NISSA SIDDIQI DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****24

License Status

ACTIVE

Business

Title

DMD

First Name

NISSA

Last Name

SIDDIQI

Business Name

NISSA SIDDIQI DMD

Original Issue Date

07/24/2023

Effective Date

09/30/2024

Expiration Date

09/30/2027

City

LOUISVILLE

State

Zip

40241

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/30/2024