SURENDRA REDDY MANDAPATI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****91

License Status

NOT RENEWED

Business

Title

DDS

First Name

SURENDRA REDDY

Last Name

MANDAPATI

Business Name

SURENDRA REDDY MANDAPATI DDS

Original Issue Date

05/27/2020

Effective Date

05/27/2020

Expiration Date

01/31/2022

City

MANCHESTER

State

Zip

06042

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022