SHUBA ANANTHA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****40

License Status

NOT RENEWED

Business

First Name

SHUBA

Last Name

ANANTHA

Suffix

DDS

Business Name

SHUBA ANANTHA DDS

Original Issue Date

01/31/2005

Effective Date

06/23/2009

Expiration Date

09/30/2012

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012