DIVYA GULATI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****96

License Status

NOT RENEWED

Business

First Name

DIVYA

Last Name

GULATI

Business Name

DIVYA GULATI

Original Issue Date

08/28/2014

Effective Date

08/28/2014

Expiration Date

09/30/2015

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016