ADHAM ABDEL AZIM BDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****24

License Status

NOT RENEWED

Business

Title

BDS

First Name

ADHAM

Last Name

ABDEL AZIM

Business Name

ADHAM ABDEL AZIM BDS

Original Issue Date

12/28/2012

Effective Date

12/28/2012

Expiration Date

09/30/2015

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016