LIYA DAVIDOVA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****82

License Status

NOT RENEWED

Business

First Name

LIYA

Last Name

DAVIDOVA

Business Name

LIYA DAVIDOVA

Original Issue Date

04/29/2019

Effective Date

11/28/2021

Expiration Date

09/30/2024

City

WAUSAU

State

Zip

54403

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025