MANISHA R PATEL DDS 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

MANISHA R

Last Name

PATEL

Suffix

DDS

Business Name

MANISHA R PATEL DDS

Original Issue Date

12/12/1996

Effective Date

12/12/1996

Expiration Date

09/30/1998

City

ROANOKE

State

Zip

61561

County

WOODFORD

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005