SHRUTI A PORE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****60

License Status

ACTIVE

Business

Title

DMD

First Name

SHRUTI

Middle

Last Name

PORE

Business Name

SHRUTI A PORE DMD

Original Issue Date

08/04/2015

Effective Date

05/14/2024

Expiration Date

09/30/2027

City

LINDENHURST

State

Zip

60046

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/14/2024