SHOUVIK PONNUSAMY DMD - Dentist License in Illinois | # 019030726

SHOUVIK PONNUSAMY DMD

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019030726

License Status

NOT RENEWED

Business

N

Title

DMD

First Name

SHOUVIK

Last Name

PONNUSAMY

Business Name

SHOUVIK PONNUSAMY DMD

Original Issue Date

06/16/2016

Effective Date

12/21/2021

Expiration Date

09/30/2024

State

IL

Ever Disciplined

N

LastModifiedDate

02/04/2025