FADI SAMIH MASOUD - Dentist License in Illinois | # 018001751

FADI SAMIH MASOUD

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001751

License Status

EXPIRED

Business

N

First Name

FADI

Middle

SAMIH

Last Name

MASOUD

Business Name

FADI SAMIH MASOUD

Original Issue Date

07/15/2009

Effective Date

07/15/2009

Expiration Date

06/30/2012

State

IL

Specialty/Qualifier

Periodontics

Ever Disciplined

N

LastModifiedDate

08/29/2012