UDAY BALKRISHNA PHATAK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****81

License Status

NOT RENEWED

Business

First Name

UDAY BALKRISHNA

Last Name

PHATAK

Business Name

UDAY BALKRISHNA PHATAK

Original Issue Date

07/30/1982

Effective Date

12/21/2021

Expiration Date

09/30/2024

City

WHEELING

State

Zip

60090

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025