CLAYTON ANTHONY LIESEN DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019033017

License Status

ACTIVE

Business

Title

DMD

First Name

CLAYTON

Middle

ANTHONY

Last Name

LIESEN

Business Name

CLAYTON ANTHONY LIESEN DMD

Original Issue Date

03/11/2021

Effective Date

08/16/2024

Expiration Date

09/30/2027

City

QUINCY

State

Zip

62305

County

ADAMS

Ever Disciplined

LastModifiedDate

08/16/2024