RANDALL EUGENE WILSON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

ACTIVE

Business

First Name

RANDALL EUGENE

Last Name

WILSON

Business Name

RANDALL EUGENE WILSON

Original Issue Date

03/18/1986

Effective Date

06/13/2024

Expiration Date

09/30/2027

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/13/2024