HASAN FAWWAZ OTHMAN - Dentist License in Illinois | # 018001178

HASAN FAWWAZ OTHMAN

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001178

License Status

NOT RENEWED

Business

N

First Name

HASAN

Middle

FAWWAZ

Last Name

OTHMAN

Business Name

HASAN FAWWAZ OTHMAN

Original Issue Date

07/07/1999

Effective Date

07/07/1999

Expiration Date

05/31/2002

State

IL

Specialty/Qualifier

Orthodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005