SHAHRBANOO FADAVI - Dentist License in Illinois | # 137000478

SHAHRBANOO FADAVI

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000478

License Status

ACTIVE

Business

N

First Name

SHAHRBANOO

Last Name

FADAVI

Business Name

SHAHRBANOO FADAVI

Original Issue Date

10/20/1999

Effective Date

06/16/2024

Expiration Date

09/30/2027

State

IL

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

N

LastModifiedDate

06/16/2024