PRATYUSHA MUPPALLA DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****51

License Status

ACTIVE

Business

Title

DDS

First Name

PRATYUSHA

Last Name

MUPPALLA

Business Name

PRATYUSHA MUPPALLA DDS

Original Issue Date

07/24/2012

Effective Date

08/23/2024

Expiration Date

09/30/2027

City

HANOVER PARK

State

Zip

60133

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/23/2024