KRISHNA D GORANTLA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****29

License Status

NOT RENEWED

Business

First Name

KRISHNA

Middle

Last Name

GORANTLA

Business Name

KRISHNA D GORANTLA

Original Issue Date

06/18/2015

Effective Date

06/18/2015

Expiration Date

09/30/2018

City

FLORA

State

Zip

62839

County

CLAY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018