MALAVIKA PRASANNA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****82

License Status

NOT RENEWED

Business

First Name

MALAVIKA

Last Name

PRASANNA DDS

Business Name

MALAVIKA PRASANNA DDS

Original Issue Date

08/16/2010

Effective Date

09/12/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60661

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016