LALEH MOAZEMI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020009408

License Status

NOT RENEWED

Business

First Name

LALEH

Last Name

MOAZEMI

Business Name

LALEH MOAZEMI

Original Issue Date

01/27/1999

Effective Date

08/23/2012

Expiration Date

09/30/2015

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

04/25/2016