KRUPA PATEL BORDATTO DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****80

License Status

ACTIVE

Business

Title

DDS

First Name

KRUPA

Middle

PATEL

Last Name

BORDATTO

Business Name

KRUPA PATEL BORDATTO DDS

Original Issue Date

07/15/2014

Effective Date

08/20/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61614

County

TAZEWELL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/20/2024