SUHASINI MANDIGA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****12

License Status

NOT RENEWED

Business

Title

DDS

First Name

SUHASINI

Last Name

MANDIGA

Business Name

SUHASINI MANDIGA DDS

Original Issue Date

08/03/2015

Effective Date

08/03/2015

Expiration Date

09/30/2018

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018