ASHISH P MEHTA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****51

License Status

NOT RENEWED

Business

Title

DMD

First Name

ASHISH

Middle

Last Name

MEHTA

Business Name

ASHISH P MEHTA DMD

Original Issue Date

04/10/2006

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009