RUSSELL G BOESTER DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****71

License Status

ACTIVE

Business

First Name

RUSSELL G

Last Name

BOESTER

Suffix

DMD

Business Name

RUSSELL G BOESTER DMD

Original Issue Date

04/12/2022

Effective Date

08/11/2024

Expiration Date

09/30/2027

City

ANNA

State

Zip

62906

County

UNION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/11/2024