BHAVANI VENKATACHALAM DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****49

License Status

NOT RENEWED

Business

First Name

BHAVANI

Last Name

VENKATACHALAM

Suffix

DMD

Business Name

BHAVANI VENKATACHALAM DMD

Original Issue Date

12/01/2011

Effective Date

12/01/2011

Expiration Date

09/30/2012

City

LOS ANGELES

State

Zip

90095

County

CALIFORNIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/14/2012