SHOUVIK PONNUSAMY DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****25

License Status

NOT RENEWED

Business

Title

DMD

First Name

SHOUVIK

Last Name

PONNUSAMY

Business Name

SHOUVIK PONNUSAMY DMD

Original Issue Date

06/16/2016

Effective Date

12/21/2021

Expiration Date

09/30/2024

City

CHICAGO

State

Zip

60607

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025