SAM DALIRI DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

NOT RENEWED

Business

Title

DMD

First Name

SAM

Last Name

DALIRI

Business Name

SAM DALIRI DMD

Original Issue Date

09/04/2019

Effective Date

12/28/2021

Expiration Date

09/30/2024

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025