MAZEN YOUSEF SULTAN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****26

License Status

NOT RENEWED

Business

Title

DMD

First Name

MAZEN

Middle

YOUSEF

Last Name

SULTAN

Business Name

MAZEN YOUSEF SULTAN DMD

Original Issue Date

04/20/2017

Effective Date

09/24/2018

Expiration Date

01/31/2022

City

SWANSEA

State

Zip

62226

County

KENTUCKY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022