IBRAHIM MASSOUD DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

ACTIVE

Business

First Name

IBRAHIM

Last Name

MASSOUD

Suffix

DDS

Business Name

IBRAHIM MASSOUD DDS

Original Issue Date

07/16/2002

Effective Date

09/30/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/30/2024