PHIL N RUCKMAN III Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****41

License Status

NOT RENEWED

Business

First Name

PHIL

Middle

Last Name

RUCKMAN III

Business Name

PHIL N RUCKMAN III

Original Issue Date

12/23/2013

Effective Date

09/23/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60604

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018