KAVITA K GUPTA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****38

License Status

NOT RENEWED

Business

First Name

KAVITA K

Last Name

GUPTA

Suffix

DDS

Business Name

KAVITA K GUPTA DDS

Original Issue Date

08/08/1995

Effective Date

08/08/1995

Expiration Date

09/30/1996

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005