FARAI W KAMBASHA DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****35

License Status

ACTIVE

Business

First Name

FARAI

Middle

Last Name

KAMBASHA

Suffix

DDS

Business Name

FARAI W KAMBASHA DDS

Original Issue Date

10/28/2005

Effective Date

08/06/2024

Expiration Date

09/30/2027

City

JOLIET

State

Zip

60435

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/06/2024