BELSAM R KASHLAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****80

License Status

NOT RENEWED

Business

First Name

BELSAM

Middle

Last Name

KASHLAN

Suffix

DDS

Business Name

BELSAM R KASHLAN DDS

Original Issue Date

07/28/2003

Effective Date

09/08/2009

Expiration Date

09/30/2012

City

DARIEN

State

Zip

60561

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012