JERRY W HUSSONG Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****28

License Status

NOT RENEWED

Business

First Name

JERRY W

Last Name

HUSSONG

Business Name

JERRY W HUSSONG

Original Issue Date

10/07/1988

Effective Date

10/07/1988

Expiration Date

09/30/1998

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005