ANJUM A ANSARI DMD - Dentist License in Illinois | # 018001112

ANJUM A ANSARI DMD

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001112

License Status

NOT RENEWED

Business

N

First Name

ANJUM

Middle

A

Last Name

ANSARI

Suffix

DMD

Business Name

ANJUM A ANSARI DMD

Original Issue Date

07/29/1998

Effective Date

07/29/1998

Expiration Date

06/30/1999

State

IL

Specialty/Qualifier

General Practice Residency

Ever Disciplined

N

LastModifiedDate

10/12/2005