RUSSELL HERBERT PITCH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****77

License Status

NOT RENEWED

Business

First Name

RUSSELL HERBERT

Last Name

PITCH

Suffix

DDS

Business Name

RUSSELL HERBERT PITCH DDS

Original Issue Date

01/01/1998

Effective Date

07/30/2018

Expiration Date

01/31/2022

City

PAXTON

State

Zip

60957

County

FORD

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022