RUSSELL JOHN PROESEL DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****30

License Status

ACTIVE

Business

First Name

RUSSELL JOHN

Last Name

PROESEL

Suffix

DDS

Business Name

RUSSELL JOHN PROESEL DDS

Original Issue Date

03/02/1982

Effective Date

05/16/2024

Expiration Date

09/30/2027

City

MOUNT ZION

State

Zip

62549

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/16/2024