KHUSHBU SURESH MODY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****42

License Status

NOT RENEWED

Business

Title

DDS

First Name

KHUSHBU

Middle

SURESH

Last Name

MODY

Business Name

KHUSHBU SURESH MODY DDS

Original Issue Date

12/07/2016

Effective Date

09/19/2018

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60605

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

05/09/2022