MUSERRAH SHUBLAQ SALEM DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****80

License Status

ACTIVE

Business

Title

DMD

First Name

MUSERRAH

Middle

SHUBLAQ

Last Name

SALEM

Business Name

MUSERRAH SHUBLAQ SALEM DMD

Original Issue Date

12/05/2018

Effective Date

09/26/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60605

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2024