KYLE BART CHRISTENSEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****31

License Status

NOT RENEWED

Business

Title

DDS

First Name

KYLE

Middle

BART

Last Name

CHRISTENSEN

Business Name

KYLE BART CHRISTENSEN DDS

Original Issue Date

09/16/2015

Effective Date

09/16/2015

Expiration Date

09/30/2018

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018