LAURA WALSH RUSSELL DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****73

License Status

INACTIVE

Business

First Name

LAURA

Last Name

WALSH RUSSELL

Suffix

DDS

Business Name

LAURA WALSH RUSSELL DDS

Original Issue Date

07/22/2003

Effective Date

07/22/2003

Expiration Date

09/30/2006

City

OAK PARK

State

Zip

60301

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/24/2006