VENKATESHWAR REDDY KOMMIDI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****08

License Status

NOT RENEWED

Business

Title

DDS

First Name

VENKATESHWAR

Middle

REDDY

Last Name

KOMMIDI

Business Name

VENKATESHWAR REDDY KOMMIDI DDS

Original Issue Date

07/21/2014

Effective Date

07/21/2014

Expiration Date

09/30/2015

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016