BHUPENDRA M MODY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000407

License Status

NOT RENEWED

Business

First Name

BHUPENDRA M

Last Name

MODY

Business Name

BHUPENDRA M MODY

Original Issue Date

08/20/1996

Effective Date

06/11/2015

Expiration Date

09/30/2018

City

WOODRIDGE

State

Zip

60517

County

DUPAGE

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

10/31/2018