C N DEVAYYA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

NOT RENEWED

Business

First Name

C N

Last Name

DEVAYYA

Business Name

C N DEVAYYA

Original Issue Date

01/01/1998

Effective Date

08/24/2015

Expiration Date

09/30/2018

City

WILLOWBROOK

State

Zip

60527

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018