HUSAM HIWIADI DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****23

License Status

NOT RENEWED

Business

Title

DMD

First Name

HUSAM

Last Name

HIWIADI

Business Name

HUSAM HIWIADI DMD

Original Issue Date

06/03/2022

Effective Date

06/03/2022

Expiration Date

09/30/2024

City

MCKINNEY

State

Zip

75070

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025