NANDINI TUMKUR SUBBARAJU 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

NANDINI TUMKUR

Last Name

SUBBARAJU

Business Name

NANDINI TUMKUR SUBBARAJU

Original Issue Date

01/01/1998

Effective Date

06/07/2018

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60608

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022