ROOPA P GANDHI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****11

License Status

NOT RENEWED

Business

First Name

ROOPA

Middle

Last Name

GANDHI

Business Name

ROOPA P GANDHI

Original Issue Date

02/16/2010

Effective Date

02/16/2010

Expiration Date

09/30/2012

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012