MUJTABA SARDAR KHAN 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

Title

DDS

First Name

MUJTABA

Middle

SARDAR

Last Name

KHAN

Business Name

MUJTABA SARDAR KHAN DDS

Original Issue Date

09/09/2016

Effective Date

09/09/2016

Expiration Date

09/30/2018

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018