RICHARD C WESTERGREN DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****90

License Status

CANCELLED

Business

First Name

RICHARD C

Last Name

WESTERGREN

Suffix

DDS

Business Name

RICHARD C WESTERGREN DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2002

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005