SIRISHA GOVINDAIAH 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

SIRISHA

Last Name

GOVINDAIAH

Suffix

DDS

Business Name

SIRISHA GOVINDAIAH DDS

Original Issue Date

08/06/2010

Effective Date

08/06/2010

Expiration Date

09/30/2012

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012