MARK EDWARD LEEDY DDS Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001795

License Status

EXPIRED

Business

Title

DDS

First Name

MARK

Middle

EDWARD

Last Name

LEEDY

Business Name

MARK EDWARD LEEDY DDS

Original Issue Date

04/04/2011

Effective Date

04/04/2011

Expiration Date

06/30/2013

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

Advanced General Dentistry

Ever Disciplined

LastModifiedDate

10/07/2013