LAWRENCE J LIESEN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****55

License Status

ACTIVE

Business

First Name

LAWRENCE J

Last Name

LIESEN

Business Name

LAWRENCE J LIESEN

Original Issue Date

08/29/1988

Effective Date

06/28/2024

Expiration Date

09/30/2027

City

GENEVA

State

Zip

60134

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/28/2024