RANDAL EUGENE WILLOUGHBY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****65

License Status

NOT RENEWED

Business

First Name

RANDAL EUGENE

Last Name

WILLOUGHBY

Business Name

RANDAL EUGENE WILLOUGHBY

Original Issue Date

01/01/1998

Expiration Date

09/30/1994

City

CHICAGO

State

Zip

60631

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005