MOHAMEDTAREK OMRAN-ALFAITUORI Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

ACTIVE

Business

First Name

MOHAMEDTAREK

Last Name

OMRAN-ALFAITUORI

Business Name

MOHAMEDTAREK OMRAN-ALFAITUORI

Original Issue Date

03/28/2012

Effective Date

08/30/2024

Expiration Date

09/30/2027

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/30/2024