THENDRAL AYANAMBAKKAM PANDURANGAN BEGAN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

ACTIVE

Business

First Name

THENDRAL

Last Name

AYANAMBAKKAM PANDURANGAN BEGAN

Business Name

THENDRAL AYANAMBAKKAM PANDURANGAN BEGAN

Original Issue Date

09/12/2023

Effective Date

09/30/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62711

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/30/2024