SHANE D RUGGLESS DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****44

License Status

ACTIVE

Business

Title

DMD

First Name

SHANE

Middle

Last Name

RUGGLESS

Business Name

SHANE D RUGGLESS DMD

Original Issue Date

09/24/2015

Effective Date

09/17/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/17/2024