ANIL PRAKASH GUDAPATI - Dentist License in Illinois | # 018001289

ANIL PRAKASH GUDAPATI

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001289

License Status

NOT RENEWED

Business

N

First Name

ANIL

Middle

PRAKASH

Last Name

GUDAPATI

Business Name

ANIL PRAKASH GUDAPATI

Original Issue Date

07/09/2001

Effective Date

07/09/2001

Expiration Date

06/30/2002

State

IL

Specialty/Qualifier

General Practice Residency

Ever Disciplined

N

LastModifiedDate

10/12/2005