TARANNUM MARYA Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****94

License Status

ACTIVE

Business

First Name

TARANNUM

Last Name

MARYA

Business Name

TARANNUM MARYA

Original Issue Date

04/22/2022

Effective Date

07/15/2024

Expiration Date

09/30/2027

City

BURR RIDGE

State

Zip

60527

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/15/2024