RUSSELL JOHN BAK DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****57

License Status

ACTIVE

Business

First Name

RUSSELL

Middle

JOHN

Last Name

BAK

Suffix

DDS

Business Name

RUSSELL JOHN BAK DDS

Original Issue Date

01/06/1999

Effective Date

09/30/2024

Expiration Date

09/30/2027

City

BOLINGBROOK

State

Zip

60440

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/30/2024