RADHIKA M GOWALI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****68

License Status

NOT RENEWED

Business

First Name

RADHIKA

Middle

Last Name

GOWALI

Suffix

DDS

Business Name

RADHIKA M GOWALI DDS

Original Issue Date

06/04/2014

Effective Date

06/04/2014

Expiration Date

09/30/2015

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016