ANISSA CELENA ANAST DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****00

License Status

ACTIVE

Business

Title

DMD

First Name

ANISSA

Middle

CELENA

Last Name

ANAST

Business Name

ANISSA CELENA ANAST DMD

Original Issue Date

05/28/2020

Effective Date

09/03/2024

Expiration Date

09/30/2027

City

LOMBARD

State

Zip

60148

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/03/2024