JYOTIRMAIE SURYADEVARA DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****46

License Status

ACTIVE

Business

Title

DMD

First Name

JYOTIRMAIE

Last Name

SURYADEVARA

Business Name

JYOTIRMAIE SURYADEVARA DMD

Original Issue Date

06/01/2023

Effective Date

08/10/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60647

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/10/2024