KELLEY A GYLLENHAAL DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****94

License Status

NOT RENEWED

Business

First Name

KELLEY

Middle

Last Name

GYLLENHAAL

Suffix

DDS

Business Name

KELLEY A GYLLENHAAL DDS

Original Issue Date

06/24/2013

Effective Date

07/16/2018

Expiration Date

01/31/2022

City

BUFFALO GROVE

State

Zip

60089

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022