JENNY M LEE-WALLE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****58

License Status

NOT RENEWED

Business

First Name

JENNY M

Last Name

LEE-WALLE

Business Name

JENNY M LEE-WALLE

Original Issue Date

11/21/1989

Effective Date

11/21/1989

Expiration Date

09/30/1992

City

CHICAGO

State

Zip

60640

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005