GLENN ROBERT POULESON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****77

License Status

ACTIVE

Business

First Name

GLENN ROBERT

Last Name

POULESON

Business Name

GLENN ROBERT POULESON

Original Issue Date

08/12/1985

Effective Date

09/20/2024

Expiration Date

09/30/2027

City

DOWNERS GROVE

State

Zip

60516

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/20/2024