SAMUEL JUN LEE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137001054

License Status

NOT RENEWED

Business

Title

DDS

First Name

SAMUEL

Middle

JUN

Last Name

LEE

Business Name

SAMUEL JUN LEE DDS

Original Issue Date

02/04/2020

Effective Date

02/04/2020

Expiration Date

01/31/2022

City

QUINCY

State

Zip

62305

County

ADAMS

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

05/09/2022