RONALD R WIDEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****27

License Status

NOT RENEWED

Business

First Name

RONALD R

Last Name

WIDEN

Business Name

RONALD R WIDEN

Original Issue Date

07/29/1985

Effective Date

07/29/1985

Expiration Date

09/30/1998

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005