AMRITA GANGULY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****55

License Status

NOT RENEWED

Business

First Name

AMRITA

Last Name

GANGULY

Business Name

AMRITA GANGULY

Original Issue Date

06/13/2013

Effective Date

06/13/2013

Expiration Date

09/30/2015

City

PEORIA

State

Zip

61603

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016