AMMAR ADAM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

NOT RENEWED

Business

First Name

AMMAR

Last Name

ADAM

Business Name

AMMAR ADAM

Original Issue Date

09/17/2008

Effective Date

08/04/2009

Expiration Date

09/30/2012

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012