LUSAI QIU Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018002057

License Status

EXPIRED

Business

First Name

LUSAI

Last Name

QIU

Business Name

LUSAI QIU

Original Issue Date

12/14/2017

Effective Date

01/09/2018

Expiration Date

06/30/2020

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

Advanced General Dentistry

Ever Disciplined

LastModifiedDate

11/19/2020