VENKAT YASHASWI KONDAPALLI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****45

License Status

NOT RENEWED

Business

Title

DDS

First Name

VENKAT

Middle

YASHASWI

Last Name

KONDAPALLI

Business Name

VENKAT YASHASWI KONDAPALLI DDS

Original Issue Date

07/25/2017

Effective Date

08/15/2018

Expiration Date

01/31/2022

City

PEORIA

State

Zip

61606

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022