AMI GIRISHKUMAR VAIDYA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****67

License Status

NOT RENEWED

Business

First Name

AMI

Middle

GIRISHKUMAR

Last Name

VAIDYA

Suffix

DMD

Business Name

AMI GIRISHKUMAR VAIDYA DMD

Original Issue Date

08/14/2009

Effective Date

09/27/2018

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60624

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022