AHMAD WALID SAMADZAI DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****49

License Status

ACTIVE

Business

First Name

AHMAD

Middle

WALID

Last Name

SAMADZAI

Suffix

DDS

Business Name

AHMAD WALID SAMADZAI DDS

Original Issue Date

04/19/2010

Effective Date

09/22/2024

Expiration Date

09/30/2027

City

MOUNT VERNON

State

Zip

62864

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/22/2024