KYLE WESLEY PETERSON DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****57

License Status

ACTIVE

Business

First Name

KYLE

Middle

WESLEY

Last Name

PETERSON

Suffix

DDS

Business Name

KYLE WESLEY PETERSON DDS

Original Issue Date

05/27/2011

Effective Date

09/18/2024

Expiration Date

09/30/2027

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/18/2024