EDWARD EMAD HASSAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****45

License Status

NOT RENEWED

Business

First Name

EDWARD

Middle

EMAD

Last Name

HASSAN

Business Name

EDWARD EMAD HASSAN

Original Issue Date

06/10/2010

Effective Date

06/10/2010

Expiration Date

09/30/2012

City

SPRING LAKE

State

Zip

49456

County

MICHIGAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/14/2012