SHAKUNTALA ADATIA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****04

License Status

NOT RENEWED

Business

First Name

SHAKUNTALA

Last Name

ADATIA

Suffix

DDS

Business Name

SHAKUNTALA ADATIA DDS

Original Issue Date

01/01/1998

Effective Date

08/09/2010

Expiration Date

09/30/2012

City

HANOVER PARK

State

Zip

60133

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012