FADI SAMIH MASOUD Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001751

License Status

EXPIRED

Business

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

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Periodontics

Ever Disciplined

LastModifiedDate

08/29/2012