ASMA M MAMSA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****26

License Status

NOT RENEWED

Business

First Name

ASMA

Middle

Last Name

MAMSA

Business Name

ASMA M MAMSA

Original Issue Date

11/26/2002

Effective Date

08/28/2009

Expiration Date

09/30/2012

City

LOMBARD

State

Zip

60148

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012