TAHANI A AL-MUSALLAM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001331

License Status

NOT RENEWED

Business

First Name

TAHANI

Middle

Last Name

AL-MUSALLAM

Suffix

DDS

Business Name

TAHANI A AL-MUSALLAM DDS

Original Issue Date

04/30/2002

Effective Date

04/30/2002

Expiration Date

05/30/2004

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

10/12/2005