SIDDHARTH BANSAL DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****68

License Status

ACTIVE

Business

First Name

SIDDHARTH

Last Name

BANSAL

Suffix

DMD

Business Name

SIDDHARTH BANSAL DMD

Original Issue Date

07/06/2011

Effective Date

07/02/2024

Expiration Date

09/30/2027

City

ELGIN

State

Zip

60061

County

KANE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/02/2024