MISTY L THILLEN 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

MISTY L

Last Name

THILLEN

Business Name

MISTY L THILLEN

Original Issue Date

06/21/1983

Effective Date

08/22/2018

Expiration Date

01/31/2022

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022