MANOJ K BAHL Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****31

License Status

NOT RENEWED

Business

First Name

MANOJ

Middle

Last Name

BAHL

Business Name

MANOJ K BAHL

Original Issue Date

03/18/2010

Effective Date

07/24/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60601

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

02/08/2016