PARIDHIE VASUDEVAN 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

PARIDHIE

Last Name

VASUDEVAN

Business Name

PARIDHIE VASUDEVAN

Original Issue Date

07/25/2018

Effective Date

07/25/2018

Expiration Date

01/31/2022

City

DEKALB

State

Zip

60115

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022