LEO LEONARD LUNDBERG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****69

License Status

NOT RENEWED

Business

First Name

LEO LEONARD

Last Name

LUNDBERG

Suffix

DDS

Business Name

LEO LEONARD LUNDBERG DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2004

City

COAL VALLEY

State

Zip

61240

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005