PRASAD B V S GONAVARUM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****17

License Status

NOT RENEWED

Business

First Name

PRASAD

Middle

B V S

Last Name

GONAVARUM

Suffix

DDS

Business Name

PRASAD B V S GONAVARUM DDS

Original Issue Date

09/09/2004

Effective Date

07/25/2018

Expiration Date

01/31/2022

City

NAPERVILLE

State

Zip

60564

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022