MEGHANA STHANAM DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****33

License Status

NOT RENEWED

Business

Title

DMD

First Name

MEGHANA

Last Name

STHANAM

Business Name

MEGHANA STHANAM DMD

Original Issue Date

08/24/2019

Effective Date

08/24/2019

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022