EMAD GUS KHALIFA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****29

License Status

NOT RENEWED

Business

First Name

EMAD

Middle

GUS

Last Name

KHALIFA

Suffix

DDS

Business Name

EMAD GUS KHALIFA DDS

Original Issue Date

11/06/2003

Effective Date

11/06/2003

Expiration Date

09/30/2006

City

ORLAND PARK

State

Zip

60462

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006