ESAM ALI ALAZZABI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****67

License Status

NOT RENEWED

Business

First Name

ESAM

Middle

ALI

Last Name

ALAZZABI

Business Name

ESAM ALI ALAZZABI

Original Issue Date

04/04/2019

Effective Date

11/20/2021

Expiration Date

09/30/2024

City

CAMAS

State

Zip

98607

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025