FADI W ROUEL DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****28

License Status

ACTIVE

Business

Title

DMD

First Name

FADI

Middle

Last Name

ROUEL

Business Name

FADI W ROUEL DMD

Original Issue Date

08/23/2019

Effective Date

08/01/2024

Expiration Date

09/30/2027

City

LOMBARD

State

Zip

60148

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/01/2024