LESLIE ANN FERNANDEZ Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020014172

License Status

INACTIVE

Business

First Name

LESLIE

Middle

ANN

Last Name

FERNANDEZ

Business Name

LESLIE ANN FERNANDEZ

Original Issue Date

09/10/2012

Effective Date

09/01/2015

Expiration Date

09/30/2018

City

ROUND LAKE BEACH

State

Zip

60073

County

LAKE

Ever Disciplined

LastModifiedDate

06/07/2018