CLARKE LESLIE JOHNSON DDS - Dentist License in Illinois | # 021000573

CLARKE LESLIE JOHNSON DDS

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000573

License Status

INACTIVE

Business

N

First Name

CLARKE LESLIE

Last Name

JOHNSON

Suffix

DDS

Business Name

CLARKE LESLIE JOHNSON DDS

Original Issue Date

12/19/1968

Effective Date

12/19/1968

Expiration Date

09/30/1996

State

IL

Specialty/Qualifier

Orthodontics

Ever Disciplined

N

LastModifiedDate

10/13/2005