DIVYA B NAGARAJ 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

DIVYA

Middle

Last Name

NAGARAJ

Business Name

DIVYA B NAGARAJ

Original Issue Date

04/23/2014

Effective Date

04/23/2014

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60613

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016