AMITA P RAVAL Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****04

License Status

ACTIVE

Business

First Name

AMITA P

Last Name

RAVAL

Business Name

AMITA P RAVAL

Original Issue Date

09/17/2021

Effective Date

05/16/2024

Expiration Date

09/30/2027

City

NEWBERRY

State

Zip

32669

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/16/2024