POONAM UDAY SHAH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000856

License Status

NOT RENEWED

Business

First Name

POONAM

Middle

UDAY

Last Name

SHAH

Suffix

DDS

Business Name

POONAM UDAY SHAH DDS

Original Issue Date

09/20/2012

Effective Date

09/20/2012

Expiration Date

09/30/2015

City

MUNSTER

State

Zip

46321

County

INDIANA

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

02/08/2016