REVATHI SHEKAR MDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****47

License Status

NOT RENEWED

Business

Title

MDS

First Name

REVATHI

Last Name

SHEKAR

Business Name

REVATHI SHEKAR MDS

Original Issue Date

03/18/2020

Effective Date

12/15/2021

Expiration Date

09/30/2024

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025