TONI LYNN RUSSO Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****57

License Status

NOT RENEWED

Business

First Name

TONI

Middle

LYNN

Last Name

RUSSO

Business Name

TONI LYNN RUSSO

Original Issue Date

05/30/2007

Effective Date

05/30/2007

Expiration Date

09/30/2009

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009