ANKUSH SHRIRAM KATKADE Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****17

License Status

ACTIVE

Business

First Name

ANKUSH

Middle

SHRIRAM

Last Name

KATKADE

Business Name

ANKUSH SHRIRAM KATKADE

Original Issue Date

01/14/2022

Effective Date

05/10/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/10/2024