RICHARD L MOUSSALLI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

NOT RENEWED

Business

First Name

RICHARD L

Last Name

MOUSSALLI

Business Name

RICHARD L MOUSSALLI

Original Issue Date

08/16/1983

Effective Date

08/16/1983

Expiration Date

09/30/1988

City

CHICAGO

State

Zip

60613

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005