TIMOTHY ANTHONY KISLA DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

ACTIVE

Business

First Name

TIMOTHY

Middle

ANTHONY

Last Name

KISLA

Suffix

Business Name

TIMOTHY ANTHONY KISLA DO

Original Issue Date

07/14/1998

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

NEW LENOX

State

Zip

60451

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023