MATIN MIKAYIL IMANGULI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000748

License Status

NOT RENEWED

Business

First Name

MATIN

Middle

MIKAYIL

Last Name

IMANGULI

Suffix

DDS

Business Name

MATIN MIKAYIL IMANGULI DDS

Original Issue Date

01/23/2009

Effective Date

12/11/2009

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

11/14/2012