AMEEN SAMEH KHRAISAT DDS - Dentist License in Illinois | # 018001494

AMEEN SAMEH KHRAISAT DDS

Business Entity

ACTIVE

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001494

License Status

ACTIVE

Business

N

First Name

AMEEN

Middle

SAMEH

Last Name

KHRAISAT

Suffix

DDS

Business Name

AMEEN SAMEH KHRAISAT DDS

Original Issue Date

09/29/2004

Effective Date

09/29/2004

Expiration Date

01/31/3004

State

IL

Specialty/Qualifier

Prosthodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005