SNOWBER FAZILI DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****45

License Status

NOT RENEWED

Business

First Name

SNOWBER

Last Name

FAZILI

Suffix

DMD

Business Name

SNOWBER FAZILI DMD

Original Issue Date

07/27/2009

Effective Date

09/10/2018

Expiration Date

01/31/2022

City

MOUNT OLIVE

State

Zip

62069

County

MACOUPIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022