REBECCA DAISY RADFAR Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

NOT RENEWED

Business

First Name

REBECCA

Middle

DAISY

Last Name

RADFAR

Business Name

REBECCA DAISY RADFAR

Original Issue Date

06/07/2011

Effective Date

06/07/2011

Expiration Date

09/30/2012

City

PHILADELPHIA

State

Zip

19103

County

PENNSYLVANIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012