PAYAL D SHROFF Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001600

License Status

CANCELLED

Business

First Name

PAYAL

Middle

Last Name

SHROFF

Business Name

PAYAL D SHROFF

Original Issue Date

07/11/2006

Effective Date

07/11/2006

Expiration Date

06/30/2007

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

06/06/2006