LESLIE EUGENE LONG - Dentist License in Illinois | # 019011136

LESLIE EUGENE LONG

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019011136

License Status

INACTIVE

Business

N

First Name

LESLIE EUGENE

Last Name

LONG

Business Name

LESLIE EUGENE LONG

Original Issue Date

08/28/1957

Effective Date

08/28/1957

Expiration Date

09/30/1990

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005