CAMERON MATTHEW RUSSELL Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019025874

License Status

NOT RENEWED

Business

First Name

CAMERON

Middle

MATTHEW

Last Name

RUSSELL

Business Name

CAMERON MATTHEW RUSSELL

Original Issue Date

06/13/2002

Effective Date

06/13/2002

Expiration Date

09/30/2004

City

NORTH OGDEN

State

Zip

84414

County

UTAH

Ever Disciplined

LastModifiedDate

10/17/2005