LEE M CERESA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

NOT RENEWED

Business

First Name

LEE

Middle

Last Name

CERESA

Suffix

DDS

Business Name

LEE M CERESA DDS

Original Issue Date

08/04/1999

Effective Date

08/04/1999

Expiration Date

09/30/2000

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005