SUCHETA RAGHAVENDRA 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

Title

DDS

First Name

SUCHETA

Last Name

RAGHAVENDRA

Business Name

SUCHETA RAGHAVENDRA DDS

Original Issue Date

08/06/2015

Effective Date

08/06/2015

Expiration Date

09/30/2018

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018