MANOUSH FARZIN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****97

License Status

NOT RENEWED

Business

Title

DMD

First Name

MANOUSH

Last Name

FARZIN

Business Name

MANOUSH FARZIN DMD

Original Issue Date

05/30/2017

Effective Date

05/30/2017

Expiration Date

09/30/2018

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018