DIVIJA TAKKALAPELLY Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019035636

License Status

ACTIVE

Business

First Name

DIVIJA

Last Name

TAKKALAPELLY

Business Name

DIVIJA TAKKALAPELLY

Original Issue Date

11/23/2024

Effective Date

11/23/2024

Expiration Date

09/30/2027

City

CHANTILLY

State

Zip

20152

Ever Disciplined

LastModifiedDate

02/24/2025