MITRA A DERAKHSHAN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019027587

License Status

NOT RENEWED

Business

First Name

MITRA

Middle

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

City

CHICAGO

State

Zip

60647

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2012