SUPRIYA GANUPUR DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****79

License Status

CANCELLED

Business

First Name

SUPRIYA

Last Name

GANUPUR

Suffix

DDS

Business Name

SUPRIYA GANUPUR DDS

Original Issue Date

10/07/2008

Effective Date

10/07/2008

Expiration Date

09/30/2009

City

CHICAGO

State

Zip

60610

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/04/2009