KRYSTLE GRANDBERRY WIDEN DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019033543

License Status

ACTIVE

Business

Title

DMD

First Name

KRYSTLE

Middle

GRANDBERRY

Last Name

WIDEN

Business Name

KRYSTLE GRANDBERRY WIDEN DMD

Original Issue Date

03/31/2022

Effective Date

07/01/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

07/01/2024