PRAVEENA VENKATA MUDDANA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****63

License Status

NOT RENEWED

Business

Title

DDS

First Name

PRAVEENA

Middle

VENKATA

Last Name

MUDDANA

Business Name

PRAVEENA VENKATA MUDDANA DDS

Original Issue Date

03/14/2013

Effective Date

03/14/2013

Expiration Date

09/30/2015

City

OAK CREEK

State

Zip

53154

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016