RONALD R WIDEN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****28

License Status

ACTIVE

Business

First Name

RONALD R

Last Name

WIDEN

Business Name

RONALD R WIDEN

Original Issue Date

08/21/1990

Effective Date

10/01/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/16/2024