SYED MUHAMMAD SHAHABUDDIN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****24

License Status

ACTIVE

Business

First Name

SYED

Middle

MUHAMMAD

Last Name

SHAHABUDDIN

Business Name

SYED MUHAMMAD SHAHABUDDIN

Original Issue Date

08/22/2017

Effective Date

07/07/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61614

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/07/2024