NEEPA BIPIN MODI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****03

License Status

NOT RENEWED

Business

First Name

NEEPA

Middle

BIPIN

Last Name

MODI

Suffix

DDS

Business Name

NEEPA BIPIN MODI DDS

Original Issue Date

10/23/2003

Effective Date

10/23/2003

Expiration Date

09/30/2004

City

AURORA

State

Zip

60506

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005