SHANE D RUGGLESS DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****98

License Status

NOT RENEWED

Business

Title

DMD

First Name

SHANE

Middle

Last Name

RUGGLESS

Business Name

SHANE D RUGGLESS DMD

Original Issue Date

06/05/2012

Effective Date

06/05/2012

Expiration Date

09/30/2015

City

AUBURN

State

Zip

62615

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016