NIDHI BAKUL KOTAK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****10

License Status

NOT RENEWED

Business

Title

DDS

First Name

NIDHI

Middle

BAKUL

Last Name

KOTAK

Business Name

NIDHI BAKUL KOTAK DDS

Original Issue Date

01/26/2015

Effective Date

07/06/2015

Expiration Date

09/30/2018

City

PHILADELPHIA

State

Zip

19130

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018