VENKATA SIVA REDDY GUVVA Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****71

License Status

ACTIVE

Business

First Name

VENKATA

Middle

SIVA REDDY

Last Name

GUVVA

Business Name

VENKATA SIVA REDDY GUVVA

Original Issue Date

09/04/2019

Effective Date

07/26/2024

Expiration Date

09/30/2027

City

COLUMBIA

State

Zip

65201

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

07/26/2024