M DERAKHSHAN Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001149

License Status

EXPIRED

Business

First Name

Last Name

DERAKHSHAN

Business Name

M DERAKHSHAN

Original Issue Date

05/10/1999

Effective Date

05/10/1999

Expiration Date

05/30/2000

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

10/12/2005