MATTHEW JOSEPH LIESEN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019030226

License Status

ACTIVE

Business

First Name

MATTHEW

Middle

JOSEPH

Last Name

LIESEN

Business Name

MATTHEW JOSEPH LIESEN

Original Issue Date

06/25/2015

Effective Date

05/16/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61602

County

PEORIA

Ever Disciplined

LastModifiedDate

05/16/2024