MAZEN EISHO DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****90

License Status

ACTIVE

Business

Title

DMD

First Name

MAZEN

Last Name

EISHO

Business Name

MAZEN EISHO DMD

Original Issue Date

08/16/2022

Effective Date

09/05/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60626

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

09/05/2024