ERICA MARIE LEE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

NOT RENEWED

Business

First Name

ERICA

Middle

MARIE

Last Name

LEE

Business Name

ERICA MARIE LEE

Original Issue Date

01/11/2011

Effective Date

07/06/2015

Expiration Date

09/30/2018

City

GURNEE

State

Zip

60031

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018