EMAD WADIE ESTAFANOUS BDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001567

License Status

NOT RENEWED

Business

First Name

EMAD

Middle

WADIE

Last Name

ESTAFANOUS

Suffix

BDS

Business Name

EMAD WADIE ESTAFANOUS BDS

Original Issue Date

09/16/2005

Effective Date

09/16/2005

Expiration Date

09/30/2006

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Maxillofacial Prosthetics

Ever Disciplined

LastModifiedDate

11/03/2006