SHIZA NUSRAT KHAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****35

License Status

NOT RENEWED

Business

Title

DDS

First Name

SHIZA

Middle

NUSRAT

Last Name

KHAN

Business Name

SHIZA NUSRAT KHAN DDS

Original Issue Date

03/27/2015

Effective Date

09/29/2015

Expiration Date

09/30/2018

City

ONEIDA

State

Zip

54155

County

WISCONSIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018