KALPANA NAGADEEPTHI KANDIMALLA Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****96

License Status

ACTIVE

Business

First Name

KALPANA

Middle

NAGADEEPTHI

Last Name

KANDIMALLA

Business Name

KALPANA NAGADEEPTHI KANDIMALLA

Original Issue Date

03/05/2007

Effective Date

08/06/2024

Expiration Date

09/30/2027

City

BOLINGBROOK

State

Zip

60490

County

WILL

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/06/2024