MUDAR AZZAM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

NOT RENEWED

Business

Title

DDS

First Name

MUDAR

Last Name

AZZAM

Business Name

MUDAR AZZAM DDS

Original Issue Date

11/15/2022

Effective Date

11/15/2022

Expiration Date

09/30/2024

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025