APARNA GOTTUMUKKULA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****27

License Status

NOT RENEWED

Business

First Name

APARNA

Last Name

GOTTUMUKKULA

Suffix

DMD

Business Name

APARNA GOTTUMUKKULA DMD

Original Issue Date

01/11/2005

Effective Date

01/11/2005

Expiration Date

09/30/2006

City

PLAINFIELD

State

Zip

60544

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006