DALLIN JAY TIPTON DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****22

License Status

NOT RENEWED

Business

Title

DMD

First Name

DALLIN

Middle

JAY

Last Name

TIPTON

Business Name

DALLIN JAY TIPTON DMD

Original Issue Date

06/27/2020

Effective Date

12/18/2021

Expiration Date

09/30/2024

City

DEKALB

State

Zip

60115

County

DEKALB

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025