JAMES L RUSSELL Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****62

License Status

NOT RENEWED

Business

First Name

JAMES L

Last Name

RUSSELL

Business Name

JAMES L RUSSELL

Original Issue Date

03/14/1996

Effective Date

03/14/1996

Expiration Date

09/30/1998

City

DUPO

State

Zip

62239

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005