SAMIR MAHENDRA PATEL DMD Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001772

License Status

EXPIRED

Business

Title

DMD

First Name

SAMIR

Middle

MAHENDRA

Last Name

PATEL

Business Name

SAMIR MAHENDRA PATEL DMD

Original Issue Date

06/28/2010

Effective Date

07/01/2010

Expiration Date

06/30/2011

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

07/19/2011