JITENDRAKUMAR V PATEL DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****91

License Status

NOT RENEWED

Business

Title

DDS

First Name

JITENDRAKUMAR

Middle

Last Name

PATEL

Business Name

JITENDRAKUMAR V PATEL DDS

Original Issue Date

07/11/2012

Effective Date

09/25/2015

Expiration Date

09/30/2018

City

DECATUR

State

Zip

62526

County

MACON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018