SURA GHAZI Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****74

License Status

ACTIVE

Business

First Name

SURA

Last Name

GHAZI

Business Name

SURA GHAZI

Original Issue Date

07/23/2019

Effective Date

06/13/2024

Expiration Date

09/30/2027

City

BENSENVILLE

State

Zip

60106

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/13/2024