AMBER IMTIAZ KHAN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****82

License Status

NOT RENEWED

Business

First Name

AMBER

Middle

IMTIAZ

Last Name

KHAN

Suffix

DMD

Business Name

AMBER IMTIAZ KHAN DMD

Original Issue Date

06/29/2005

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009