LESLIE ANN RAYBURN SHURSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020005692

License Status

NOT RENEWED

Business

First Name

LESLIE ANN

Last Name

RAYBURN SHURSON

Business Name

LESLIE ANN RAYBURN SHURSON

BusinessDBA

RAYBURN LESLIE A.

Original Issue Date

09/10/1984

Effective Date

10/01/2006

Expiration Date

09/30/2009

City

EVERGREEN PARK

State

Zip

60805

County

COOK

Ever Disciplined

LastModifiedDate

11/04/2009

Case Number

1988002317

Action

Probation

Discipline Start Date

02/04/1991

Discipline End Date

03/13/1997

Discipline Reason

Defaulted on an Illinois Student Assistance loan.