SOWMYA MYSORE-RAJAGOPAL DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****13

License Status

NOT RENEWED

Business

Title

DDS

First Name

SOWMYA

Last Name

MYSORE-RAJAGOPAL

Business Name

SOWMYA MYSORE-RAJAGOPAL DDS

Original Issue Date

08/31/2015

Effective Date

08/31/2015

Expiration Date

09/30/2018

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018