KEITH RUSSELL RUTER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****52

License Status

NOT RENEWED

Business

First Name

KEITH RUSSELL

Last Name

RUTER

Business Name

KEITH RUSSELL RUTER

Original Issue Date

08/07/1985

Effective Date

06/20/2018

Expiration Date

01/31/2022

City

FORRESTON

State

Zip

61030

County

OGLE

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/09/2022