GIRISH BANAJI DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****83

License Status

CANCELLED

Business

First Name

GIRISH

Last Name

BANAJI

Suffix

DDS

Business Name

GIRISH BANAJI DDS

Original Issue Date

12/13/1993

Effective Date

12/13/1993

Expiration Date

09/30/2002

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005