License holder summary

Prathip Sivaprakasam is a Controlled Substance Registration - Dentist licensed to practice in Indiana. The address on file for Prathip Sivaprakasam is 1515 West 45th Ave., Griffith IN 46319. This licensed professional license is not current. The license was granted 05/01/2008 and expired on 03/01/2012.

Indiana

Professional Licensing Agency

Prathip Sivaprakasam
Controlled Substance Registration - Dentist
License number
12011107B
Date granted
05/01/2008
Date expires
03/01/2012
Class
Controlled Substance Registration - Dentist
Status
Expired
Address
1515 West 45th Ave., Griffith IN 46319
indianalicensing.org
ID 5099762
LAST UPDATED 2024-04-02 08:18:05 UTC

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