HOOMAN SHAKIBA DMD Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019024099

License Status

INACTIVE

Business

First Name

HOOMAN

Last Name

SHAKIBA

Suffix

DMD

Business Name

HOOMAN SHAKIBA DMD

Original Issue Date

02/21/1996

Effective Date

02/21/1996

Expiration Date

09/30/1996

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

10/12/2005