LEE M CERESA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****62

License Status

NOT RENEWED

Business

First Name

LEE

Middle

Last Name

CERESA

Suffix

DDS

Business Name

LEE M CERESA DDS

Original Issue Date

01/29/1996

Effective Date

01/29/1996

Expiration Date

09/30/1996

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005