BASSEL SAMIR HADDAD DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****61

License Status

NOT RENEWED

Business

Title

DDS

First Name

BASSEL

Middle

SAMIR

Last Name

HADDAD

Business Name

BASSEL SAMIR HADDAD DDS

Original Issue Date

01/30/2014

Effective Date

01/30/2014

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60605

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

02/08/2016