FOROUD TALE-YAZDI DDS 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

FOROUD

Last Name

TALE-YAZDI

Suffix

DDS

Business Name

FOROUD TALE-YAZDI DDS

Original Issue Date

11/30/2006

Effective Date

11/30/2006

Expiration Date

09/30/2009

City

ROMEOVILLE

State

Zip

60446

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/04/2009