ROLAND SHASTRI OUTARSINGH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000626

License Status

NOT RENEWED

Business

First Name

ROLAND

Middle

SHASTRI

Last Name

OUTARSINGH

Suffix

DDS

Business Name

ROLAND SHASTRI OUTARSINGH DDS

Original Issue Date

07/01/1992

Effective Date

07/01/1992

Expiration Date

06/30/1994

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Prosthodontics

Ever Disciplined

LastModifiedDate

10/12/2005