RUSSELL J CECALA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****43

License Status

NOT RENEWED

Business

First Name

RUSSELL J

Last Name

CECALA

Suffix

DDS

Business Name

RUSSELL J CECALA DDS

Original Issue Date

12/05/2002

Effective Date

12/05/2002

Expiration Date

09/30/2004

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005