LESLIE HAROLD DIX Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****23

License Status

NOT RENEWED

Business

First Name

LESLIE HAROLD

Last Name

DIX

Business Name

LESLIE HAROLD DIX

Original Issue Date

01/01/1998

Expiration Date

09/30/1986

City

PERU

State

Zip

61354

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005