LANCE LESLIE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

ACTIVE

Business

Title

DMD

First Name

LANCE

Last Name

LESLIE

Business Name

LANCE LESLIE DMD

Original Issue Date

07/22/2022

Effective Date

07/18/2024

Expiration Date

09/30/2027

City

COLLINSVILLE

State

Zip

62234

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/18/2024