SHIZA NUSRAT KHAN DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021002576

License Status

INACTIVE

Business

Title

DDS

First Name

SHIZA

Middle

NUSRAT

Last Name

KHAN

Business Name

SHIZA NUSRAT KHAN DDS

Original Issue Date

07/28/2014

Effective Date

09/18/2018

Expiration Date

12/31/2021

City

ONEIDA

State

Zip

54155

County

WISCONSIN

Specialty/Qualifier

PERIODONTICS

Ever Disciplined

LastModifiedDate

12/20/2021