DIPALI D THAKKER DMD 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

DIPALI

Middle

Last Name

THAKKER

Suffix

DMD

Business Name

DIPALI D THAKKER DMD

Original Issue Date

07/19/2005

Effective Date

08/20/2018

Expiration Date

01/31/2022

City

SHILOH

State

Zip

62269

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022