KYLE E PEDERSEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****63

License Status

NOT RENEWED

Business

First Name

KYLE

Middle

Last Name

PEDERSEN

Suffix

DDS

Business Name

KYLE E PEDERSEN DDS

Original Issue Date

08/29/1994

Effective Date

06/26/2012

Expiration Date

09/30/2015

City

SAINT CHARLES

State

Zip

60174

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016