SADAF SAFAVINEJAD DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****05

License Status

NOT RENEWED

Business

Title

DDS

First Name

SADAF

Last Name

SAFAVINEJAD

Business Name

SADAF SAFAVINEJAD DDS

Original Issue Date

09/03/2014

Effective Date

06/23/2015

Expiration Date

09/30/2018

City

MACHESNEY PARK

State

Zip

61115

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018