ANISHA VARGHESE CHERUVILLIL Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****74

License Status

ACTIVE

Business

First Name

ANISHA

Middle

VARGHESE

Last Name

CHERUVILLIL

Business Name

ANISHA VARGHESE CHERUVILLIL

Original Issue Date

09/29/2018

Effective Date

08/29/2024

Expiration Date

09/30/2027

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/29/2024