TARIQ IMAD GHAZAWI DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****99

License Status

ACTIVE

Business

Title

DMD

First Name

TARIQ

Middle

IMAD

Last Name

GHAZAWI

Business Name

TARIQ IMAD GHAZAWI DMD

Original Issue Date

07/29/2024

Effective Date

07/29/2024

Expiration Date

09/30/2027

City

BRIDGEVIEW

State

Zip

60455

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/29/2024