KENNETH R PICKETT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000389

License Status

NOT RENEWED

Business

First Name

KENNETH R

Last Name

PICKETT

Suffix

DDS

Business Name

KENNETH R PICKETT DDS

Original Issue Date

11/20/1995

Effective Date

06/04/2009

Expiration Date

09/30/2012

City

NAPERVILLE

State

Zip

60565

County

DUPAGE

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

11/14/2012