M DERAKHSHAN - Dentist License in Illinois | # 018001149

M DERAKHSHAN

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001149

License Status

EXPIRED

Business

N

First Name

M

Last Name

DERAKHSHAN

Business Name

M DERAKHSHAN

Original Issue Date

05/10/1999

Effective Date

05/10/1999

Expiration Date

05/30/2000

State

IL

Specialty/Qualifier

Orthodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005