SHUBADHA VIRENJAN DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****45

License Status

CANCELLED

Business

First Name

SHUBADHA

Last Name

VIRENJAN

Suffix

DDS

Business Name

SHUBADHA VIRENJAN DDS

Original Issue Date

11/20/2003

Effective Date

11/20/2003

Expiration Date

09/30/2006

City

NAPERVILLE

State

Zip

60564

County

WILL

Controlled Substance Schedule

IV V

Ever Disciplined

LastModifiedDate

07/24/2006