GEETHA DUDDANAHALLI SIDDANNA Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****03

License Status

ACTIVE

Business

First Name

GEETHA

Last Name

DUDDANAHALLI SIDDANNA

Business Name

GEETHA DUDDANAHALLI SIDDANNA

Original Issue Date

05/06/2022

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

ANN ARBOR

State

Zip

48108

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/01/2024