KEVIN J WYSOCKI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****35

License Status

NOT RENEWED

Business

First Name

KEVIN J

Last Name

WYSOCKI

Business Name

KEVIN J WYSOCKI

Original Issue Date

10/16/1990

Effective Date

08/30/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60643

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016