KEVIN LEE THEISS DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****13

License Status

NOT RENEWED

Business

Title

DMD

First Name

KEVIN

Middle

LEE

Last Name

THEISS

Business Name

KEVIN LEE THEISS DMD

Original Issue Date

12/14/2015

Effective Date

10/22/2021

Expiration Date

09/30/2024

City

CRYSTAL LAKE

State

Zip

60012

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025