KASHYAP KRISHNA MADDALI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****63

License Status

NOT RENEWED

Business

Title

DDS

First Name

KASHYAP

Middle

KRISHNA

Last Name

MADDALI

Business Name

KASHYAP KRISHNA MADDALI DDS

Original Issue Date

06/16/2023

Effective Date

06/16/2023

Expiration Date

09/30/2024

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/18/2026