KYLE WILSON HEATON DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****08

License Status

NOT RENEWED

Business

Title

DMD

First Name

KYLE

Middle

WILSON

Last Name

HEATON

Business Name

KYLE WILSON HEATON DMD

Original Issue Date

08/09/2006

Effective Date

09/11/2012

Expiration Date

09/30/2015

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016