MIRETTE BOUSHRA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****36

License Status

NOT RENEWED

Business

Title

DMD

First Name

MIRETTE

Last Name

BOUSHRA

Business Name

MIRETTE BOUSHRA DMD

Original Issue Date

08/09/2019

Effective Date

12/30/2021

Expiration Date

09/30/2024

City

ALEXANDRIA

State

Zip

22314

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025