KEVIN J WYSOCKI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****34

License Status

NOT RENEWED

Business

First Name

KEVIN J

Last Name

WYSOCKI

Business Name

KEVIN J WYSOCKI

Original Issue Date

12/12/1988

Effective Date

12/12/1988

Expiration Date

09/30/1992

City

CHICAGO

State

Zip

60629

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005