MITRA A DERAKHSHAN DMD - Dentist License in Illinois | # 019027587

MITRA A DERAKHSHAN DMD

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019027587

License Status

NOT RENEWED

Business

N

First Name

MITRA

Middle

A

Last Name

DERAKHSHAN

Suffix

DMD

Business Name

MITRA A DERAKHSHAN DMD

Original Issue Date

03/24/2008

Effective Date

08/26/2009

Expiration Date

09/30/2012

State

IL

Ever Disciplined

N

LastModifiedDate

11/14/2012