RICK THEUNINCK LEPPO DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****88

License Status

NOT RENEWED

Business

Title

DMD

First Name

RICK

Middle

THEUNINCK

Last Name

LEPPO

Business Name

RICK THEUNINCK LEPPO DMD

Original Issue Date

06/11/2008

Effective Date

03/16/2010

Expiration Date

09/30/2012

City

ORION

State

Zip

61273

County

HENRY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012