ANJUM A ANSARI DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001112

License Status

NOT RENEWED

Business

First Name

ANJUM

Middle

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

City

EVANSTON

State

Zip

60201

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005