RAMBOD SAEEDI FARD DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****28

License Status

NOT RENEWED

Business

First Name

RAMBOD

Middle

SAEEDI

Last Name

FARD

Suffix

DDS

Business Name

RAMBOD SAEEDI FARD DDS

Original Issue Date

07/07/2004

Effective Date

07/07/2004

Expiration Date

09/30/2006

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006