Kleyn Birdwell Russell Jr Dds

License

Licensed by

Illinois Department of Financial and Professional Regulation

License number

019016923

Status

Suspended

First issued

August 14, 1979

Expired

September 30, 1992

License holder

Kleyn Birdwell Russell Jr Dds

Entity type

Individual

Classifications

• Licensed Dentist (Dental) Dental

More from the license record

Current term began

08/14/1979

Ever disciplined

Yes

Discipline case

1992003150

Discipline action

Suspension

Discipline reason

Disciplined in Oklahoma and Florida.

Discipline dates

12/28/1993

Other Illinois licenses under this name

• IL
  Kleyn Birdwell Russell Jr Dds

  License 31*****81

  Licensed Dentist Controlled Substance (Dental)
  Expired

  Decatur, IL

  Expired Sep 30, 1992

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