COURTNEY R LEVINE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****28

License Status

NOT RENEWED

Business

First Name

COURTNEY

Middle

Last Name

LEVINE

Business Name

COURTNEY R LEVINE

Original Issue Date

07/26/2011

Effective Date

07/26/2011

Expiration Date

09/30/2012

City

KENOSHA

State

Zip

53143

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012