DALE GLEN CLAUSSEN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****83

License Status

NOT RENEWED

Business

First Name

DALE GLEN

Last Name

CLAUSSEN

Suffix

DMD

Business Name

DALE GLEN CLAUSSEN DMD

Original Issue Date

01/01/1998

Effective Date

06/13/2018

Expiration Date

01/31/2022

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022