JOSEPH R TYSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

NOT RENEWED

Business

First Name

JOSEPH R

Last Name

TYSON

Suffix

DDS

Business Name

JOSEPH R TYSON DDS

Original Issue Date

10/17/1996

Effective Date

10/17/1996

Expiration Date

09/30/2002

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005