MANITA GROVER UTREJA DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****25

License Status

ACTIVE

Business

Title

DMD

First Name

MANITA

Middle

GROVER

Last Name

UTREJA

Business Name

MANITA GROVER UTREJA DMD

Original Issue Date

09/04/2020

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

EDWARDSVILLE

State

Zip

62025

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/25/2024