SUE EILEEN LIEBENTHAL Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****81

License Status

NOT RENEWED

Business

First Name

SUE EILEEN

Last Name

LIEBENTHAL

Business Name

SUE EILEEN LIEBENTHAL

Original Issue Date

08/16/1983

Effective Date

08/16/1983

Expiration Date

09/30/1986

City

SOUTH HOLLAND

State

Zip

60433

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005