SHIMA BASHIRA PHOENIX DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****59

License Status

ACTIVE

Business

Title

DMD

First Name

SHIMA

Middle

BASHIRA

Last Name

PHOENIX

Business Name

SHIMA BASHIRA PHOENIX DMD

Original Issue Date

08/04/2015

Effective Date

08/10/2024

Expiration Date

09/30/2027

City

ALBUQUERQUE

State

Zip

87108

County

JEFFERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/10/2024