PRAVEEN KUMAR GONUGUNTLA KAMMA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019032826

License Status

NOT RENEWED

Business

Title

DMD

First Name

PRAVEEN KUMAR

Last Name

GONUGUNTLA KAMMA

Business Name

PRAVEEN KUMAR GONUGUNTLA KAMMA DMD

Original Issue Date

07/21/2020

Effective Date

07/21/2020

Expiration Date

01/31/2022

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Ever Disciplined

LastModifiedDate

05/09/2022