KETLEN KRISTIAN BYSTROM Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000198

License Status

EXPIRED

Business

First Name

KETLEN

Middle

KRISTIAN

Last Name

BYSTROM

Business Name

KETLEN KRISTIAN BYSTROM

Original Issue Date

01/29/2015

Effective Date

02/01/2015

Expiration Date

01/31/2018

City

ORLAND PARK

State

Zip

60467

County

COOK

Ever Disciplined

LastModifiedDate

04/10/2018