KELLY ANN KIRTLAND DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****18

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

ANN

Last Name

KIRTLAND

Suffix

DDS

Business Name

KELLY ANN KIRTLAND DDS

Original Issue Date

12/14/2001

Effective Date

09/02/2015

Expiration Date

09/30/2018

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018