CALYSTA C HARRIS-BEATTY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****87

License Status

NOT RENEWED

Business

First Name

CALYSTA

Middle

Last Name

HARRIS-BEATTY

Suffix

DDS

Business Name

CALYSTA C HARRIS-BEATTY DDS

Original Issue Date

02/07/2012

Effective Date

08/30/2012

Expiration Date

09/30/2015

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016