MICHELE JUNE LEE DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****52

License Status

NOT RENEWED

Business

First Name

MICHELE

Middle

JUNE

Last Name

LEE

Suffix

DMD

Business Name

MICHELE JUNE LEE DMD

Original Issue Date

04/20/2010

Effective Date

04/20/2010

Expiration Date

09/30/2012

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012