CHARMAINE AUDREY LEONG - Dentist License in Illinois | # 018001156

CHARMAINE AUDREY LEONG

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001156

License Status

NOT RENEWED

Business

N

First Name

CHARMAINE

Middle

AUDREY

Last Name

LEONG

Business Name

CHARMAINE AUDREY LEONG

Original Issue Date

06/07/1999

Effective Date

06/07/1999

Expiration Date

06/30/2001

State

IL

Specialty/Qualifier

General Practice Residency

Ever Disciplined

N

LastModifiedDate

10/12/2005