VEERDHAVAL VISHWASRAO PITALE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

NOT RENEWED

Business

First Name

VEERDHAVAL

Last Name

VISHWASRAO PITALE

Business Name

VEERDHAVAL VISHWASRAO PITALE

Original Issue Date

07/13/1992

Effective Date

06/18/2015

Expiration Date

09/30/2018

City

SALEM

State

Zip

62801

County

MARION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018