JYOTIRMAIE SURYADEVARA DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137001127

License Status

ACTIVE

Business

Title

DMD

First Name

JYOTIRMAIE

Last Name

SURYADEVARA

Business Name

JYOTIRMAIE SURYADEVARA DMD

Original Issue Date

10/04/2023

Effective Date

08/10/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60647

County

COOK

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

08/10/2024