OUSAMA ANTOON DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000485

License Status

NOT RENEWED

Business

First Name

OUSAMA

Last Name

ANTOON

Suffix

DMD

Business Name

OUSAMA ANTOON DMD

Original Issue Date

07/26/1990

Effective Date

07/26/1990

Expiration Date

06/30/1991

City

EAST ST LOUIS

State

Zip

62201

County

SAINT CLAIR

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005