GEORGEA BABY THEKKETHOTTIYIL DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

NOT RENEWED

Business

First Name

GEORGEA

Middle

BABY

Last Name

THEKKETHOTTIYIL

Suffix

DDS

Business Name

GEORGEA BABY THEKKETHOTTIYIL DDS

Original Issue Date

07/31/2012

Effective Date

07/31/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016