MATIN MIKAYIL IMANGULI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

NOT RENEWED

Business

First Name

MATIN

Middle

MIKAYIL

Last Name

IMANGULI

Suffix

DDS

Business Name

MATIN MIKAYIL IMANGULI DDS

Original Issue Date

02/26/2009

Effective Date

12/21/2009

Expiration Date

09/30/2012

City

MORTON GROVE

State

Zip

60053

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012