KEVIN WILSON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****76

License Status

ACTIVE

Business

First Name

KEVIN

Last Name

WILSON

Business Name

KEVIN WILSON

Original Issue Date

11/22/2019

Effective Date

08/05/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60643

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/05/2024