SOUMYA PADALA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****61

License Status

NOT RENEWED

Business

First Name

SOUMYA

Last Name

PADALA

Business Name

SOUMYA PADALA

Original Issue Date

10/09/2015

Effective Date

07/11/2018

Expiration Date

01/31/2022

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/09/2022