RUSSELL P PESAVENTO DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

ACTIVE

Business

Title

DDS

First Name

RUSSELL

Middle

Last Name

PESAVENTO

Business Name

RUSSELL P PESAVENTO DDS

Original Issue Date

12/03/2021

Effective Date

08/31/2024

Expiration Date

09/30/2027

City

JOLIET

State

Zip

60435

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/31/2024