GURSIMRAN REEN MANAISE DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****45

License Status

NOT RENEWED

Business

First Name

GURSIMRAN

Middle

REEN

Last Name

MANAISE

Suffix

DMD

Business Name

GURSIMRAN REEN MANAISE DMD

Original Issue Date

09/06/2017

Effective Date

08/20/2018

Expiration Date

01/31/2022

City

FORT WAYNE

State

Zip

46835

County

INDIANA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022