SRINIVAS R DURSHANAPALLI Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****23

License Status

ACTIVE

Business

First Name

SRINIVAS

Middle

Last Name

DURSHANAPALLI

Business Name

SRINIVAS R DURSHANAPALLI

Original Issue Date

07/25/2011

Effective Date

09/25/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2024