KEERTHI GOLLA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

NOT RENEWED

Business

First Name

KEERTHI

Last Name

GOLLA

Suffix

DMD

Business Name

KEERTHI GOLLA DMD

Original Issue Date

08/02/2004

Effective Date

08/01/2012

Expiration Date

09/30/2015

City

OAKBROOK

State

Zip

60523

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016