CLARKE LESLIE JOHNSON DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012498

License Status

INACTIVE

Business

First Name

CLARKE LESLIE

Last Name

JOHNSON

Suffix

DDS

Business Name

CLARKE LESLIE JOHNSON DDS

Original Issue Date

07/14/1964

Effective Date

07/14/1964

Expiration Date

09/30/1996

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

10/12/2005