MOON SOO LEE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****39

License Status

NOT RENEWED

Business

First Name

MOON SOO

Last Name

LEE

Business Name

MOON SOO LEE

Original Issue Date

12/24/1986

Effective Date

12/24/1986

Expiration Date

09/30/1990

City

WAUWATOSA

State

Zip

53226

County

WISCONSIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005