BLASE MICHAEL LEON - Dentist License in Illinois | # 019010744

BLASE MICHAEL LEON

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019010744

License Status

NOT RENEWED

Business

N

First Name

BLASE MICHAEL

Last Name

LEON

Business Name

BLASE MICHAEL LEON

Original Issue Date

08/16/1955

Effective Date

07/03/2012

Expiration Date

09/30/2015

State

IL

Ever Disciplined

N

LastModifiedDate

02/08/2016