ANASS KOLEILAT Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****14

License Status

NOT RENEWED

Business

First Name

ANASS

Last Name

KOLEILAT

Business Name

ANASS KOLEILAT

Original Issue Date

09/21/2021

Effective Date

09/21/2021

Expiration Date

09/30/2024

City

STOW

State

Zip

44224

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025