MANGAYARKARASI MATHIYAZHAGAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

NOT RENEWED

Business

Title

DDS

First Name

MANGAYARKARASI

Last Name

MATHIYAZHAGAN

Business Name

MANGAYARKARASI MATHIYAZHAGAN DDS

Original Issue Date

07/24/2012

Effective Date

07/24/2012

Expiration Date

09/30/2015

City

PEORIA

State

Zip

61614

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016