ALEX A TAVASOLI DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****94

License Status

NOT RENEWED

Business

Title

DMD

First Name

ALEX

Middle

Last Name

TAVASOLI

Business Name

ALEX A TAVASOLI DMD

Original Issue Date

06/29/2023

Effective Date

06/29/2023

Expiration Date

09/30/2024

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025