FABIAN GREGORY HOSEIN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****75

License Status

ACTIVE

Business

First Name

FABIAN

Middle

GREGORY

Last Name

HOSEIN

Business Name

FABIAN GREGORY HOSEIN

Original Issue Date

01/16/2007

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2024