CHARMAINE AUDREY LEONG Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001156

License Status

NOT RENEWED

Business

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

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005