PUNITA SHUKLA PONNUSAMY DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****61

License Status

NOT RENEWED

Business

Title

DMD

First Name

PUNITA

Middle

SHUKLA

Last Name

PONNUSAMY

Business Name

PUNITA SHUKLA PONNUSAMY DMD

Original Issue Date

06/03/2016

Effective Date

12/16/2021

Expiration Date

09/30/2024

City

CEDAR PARK

State

Zip

78613

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025