MATTHEW EDWARD RUSS DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****94

License Status

ACTIVE

Business

Title

DMD

First Name

MATTHEW

Middle

EDWARD

Last Name

RUSS

Business Name

MATTHEW EDWARD RUSS DMD

Original Issue Date

08/23/2019

Effective Date

08/11/2024

Expiration Date

09/30/2027

City

NAPERVILLE

State

Zip

60564

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/11/2024