JACK TSUNG LEE LIU Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****76

License Status

NOT RENEWED

Business

First Name

JACK

Middle

TSUNG LEE

Last Name

LIU

Business Name

JACK TSUNG LEE LIU

Original Issue Date

02/27/1985

Effective Date

06/24/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60601

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018