JENNIE DARA LEIKIN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

NOT RENEWED

Business

Title

DMD

First Name

JENNIE

Middle

DARA

Last Name

LEIKIN

Business Name

JENNIE DARA LEIKIN DMD

Original Issue Date

06/15/2016

Effective Date

06/15/2016

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018