PRIYANKA SHAH-MODI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

NOT RENEWED

Business

Title

DDS

First Name

PRIYANKA

Last Name

SHAH-MODI

Business Name

PRIYANKA SHAH-MODI DDS

Original Issue Date

08/05/2013

Effective Date

08/19/2015

Expiration Date

09/30/2018

City

BARTLETT

State

Zip

60103

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018