JAI KRISHNA SRIKANTH KOLLIBOYANA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****86

License Status

NOT RENEWED

Business

Title

DDS

First Name

JAI KRISHNA SRIKANTH

Last Name

KOLLIBOYANA

Business Name

JAI KRISHNA SRIKANTH KOLLIBOYANA DDS

Original Issue Date

08/22/2019

Effective Date

08/22/2019

Expiration Date

01/31/2022

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022