DELSAZ MOHAMED SAID SULTAN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****98

License Status

NOT RENEWED

Business

Title

DMD

First Name

DELSAZ

Middle

MOHAMED SAID

Last Name

SULTAN

Business Name

DELSAZ MOHAMED SAID SULTAN DMD

Original Issue Date

03/22/2017

Effective Date

03/22/2017

Expiration Date

09/30/2018

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018