TAPAN PATEL DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****26

License Status

NOT RENEWED

Business

First Name

TAPAN

Last Name

PATEL

Suffix

DMD

Business Name

TAPAN PATEL DMD

Original Issue Date

04/06/2012

Effective Date

04/06/2012

Expiration Date

09/30/2012

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012