KHALDOUN M TARABIN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****31

License Status

NOT RENEWED

Business

First Name

KHALDOUN

Middle

Last Name

TARABIN

Suffix

DMD

Business Name

KHALDOUN M TARABIN DMD

Original Issue Date

05/03/1999

Effective Date

05/03/1999

Expiration Date

09/30/2002

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/17/2005