AZZA TAGELSIR M AHMED Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****75

License Status

ACTIVE

Business

First Name

AZZA

Middle

TAGELSIR M

Last Name

AHMED

Business Name

AZZA TAGELSIR M AHMED

Original Issue Date

10/27/2022

Effective Date

09/01/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/01/2024