RAFAT M MANSOUR DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****58

License Status

NOT RENEWED

Business

First Name

RAFAT M

Last Name

MANSOUR

Suffix

DDS

Business Name

RAFAT M MANSOUR DDS

Original Issue Date

12/16/1996

Effective Date

12/16/1996

Expiration Date

09/30/2000

City

WAUKEGAN

State

Zip

60085

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005