BALASUDHA BALADHANDAYUTHAM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

NOT RENEWED

Business

First Name

BALASUDHA

Last Name

BALADHANDAYUTHAM

Business Name

BALASUDHA BALADHANDAYUTHAM

Original Issue Date

09/13/2016

Effective Date

09/13/2016

Expiration Date

09/30/2018

City

ROCHESTER

State

Zip

14620

County

NEW YORK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018