ANIL PRAKASH GUDAPATI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

NOT RENEWED

Business

First Name

ANIL

Middle

PRAKASH

Last Name

GUDAPATI

Business Name

ANIL PRAKASH GUDAPATI

Original Issue Date

10/17/2002

Effective Date

10/17/2002

Expiration Date

09/30/2004

City

LOMBARD

State

Zip

60148

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005