FADI SAMIH MASOUD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****81

License Status

ACTIVE

Business

First Name

FADI

Middle

SAMIH

Last Name

MASOUD

Business Name

FADI SAMIH MASOUD

Original Issue Date

12/15/2009

Effective Date

10/01/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60647

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/28/2024