SHAHLA RAVANBAKHSH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****52

License Status

NOT RENEWED

Business

First Name

SHAHLA

Last Name

RAVANBAKHSH

Suffix

DDS

Business Name

SHAHLA RAVANBAKHSH DDS

Original Issue Date

09/13/1990

Effective Date

09/13/1990

Expiration Date

09/30/1992

City

CHICAGO

State

Zip

60630

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005