RUSTIN A WEST DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

NOT RENEWED

Business

First Name

RUSTIN

Middle

Last Name

WEST

Suffix

DDS

Business Name

RUSTIN A WEST DDS

Original Issue Date

11/10/2005

Effective Date

11/10/2005

Expiration Date

09/30/2006

City

WISCONSIN

State

Zip

53233

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006