KENNETH R PICKETT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****97

License Status

NOT RENEWED

Business

First Name

KENNETH R

Last Name

PICKETT

Suffix

DDS

Business Name

KENNETH R PICKETT DDS

Original Issue Date

10/28/1992

Effective Date

10/28/1992

Expiration Date

09/30/1996

City

BOLINGBROOK

State

Zip

60440

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005