HASAN FAWWAZ OTHMAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001178

License Status

NOT RENEWED

Business

First Name

HASAN

Middle

FAWWAZ

Last Name

OTHMAN

Business Name

HASAN FAWWAZ OTHMAN

Original Issue Date

07/07/1999

Effective Date

07/07/1999

Expiration Date

05/31/2002

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

10/12/2005