KYLE ANTONY CHIN Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****83

License Status

CANCELLED

Business

First Name

KYLE

Middle

ANTONY

Last Name

CHIN

Business Name

KYLE ANTONY CHIN

Original Issue Date

03/06/2002

Effective Date

03/06/2002

Expiration Date

09/30/2004

City

CHICAGO

State

Zip

60632

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005