MARYAM MOGHADAM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****97

License Status

NOT RENEWED

Business

First Name

MARYAM

Last Name

MOGHADAM

Business Name

MARYAM MOGHADAM

Original Issue Date

07/19/2002

Effective Date

10/01/2021

Expiration Date

09/30/2024

City

CHICAGO

State

Zip

60639

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025