TARA ELIZABETH HABIBI DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****73

License Status

ACTIVE

Business

Title

DMD

First Name

TARA

Middle

ELIZABETH

Last Name

HABIBI

Business Name

TARA ELIZABETH HABIBI DMD

Original Issue Date

10/13/2021

Effective Date

08/23/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62711

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/23/2024