LESLIE B WARDELL Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****56

License Status

NOT RENEWED

Business

First Name

LESLIE B

Last Name

WARDELL

Business Name

LESLIE B WARDELL

Original Issue Date

01/11/1990

Effective Date

01/11/1990

Expiration Date

09/30/1992

City

ELMHURST

State

Zip

60126

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005