BHARATH VAMSI KRISHNA SREEKANTAM Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****97

License Status

ACTIVE

Business

First Name

BHARATH VAMSI KRISHNA

Last Name

SREEKANTAM

Business Name

BHARATH VAMSI KRISHNA SREEKANTAM

Original Issue Date

11/05/2021

Effective Date

09/26/2024

Expiration Date

09/30/2027

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2024