YASHODHAN NITEEN GHODKE DMD Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****00

License Status

INACTIVE

Business

Title

DMD

First Name

YASHODHAN

Middle

NITEEN

Last Name

GHODKE

Business Name

YASHODHAN NITEEN GHODKE DMD

Original Issue Date

06/27/2017

Effective Date

08/06/2018

Expiration Date

12/31/2021

City

PEORIA

State

Zip

61614

County

PENNSYLVANIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/21/2021