KRUPALI THACKER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****83

License Status

NOT RENEWED

Business

First Name

KRUPALI

Last Name

THACKER

Business Name

KRUPALI THACKER

Original Issue Date

06/10/2008

Effective Date

06/04/2009

Expiration Date

09/30/2012

City

MOUNT PROSPECT

State

Zip

60056

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/14/2013