DIVYA AMBARISH PATHAK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****59

License Status

NOT RENEWED

Business

First Name

DIVYA AMBARISH

Last Name

PATHAK

Suffix

DDS

Business Name

DIVYA AMBARISH PATHAK DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1984

City

ELMHURST

State

Zip

60126

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005