ALLEN PONDEVIDA MOMONGAN DDS - Dentist License in Illinois | # 018000783

ALLEN PONDEVIDA MOMONGAN DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000783

License Status

NOT RENEWED

Business

N

First Name

ALLEN PONDEVIDA

Last Name

MOMONGAN

Suffix

DDS

Business Name

ALLEN PONDEVIDA MOMONGAN DDS

Original Issue Date

07/05/1994

Effective Date

07/05/1994

Expiration Date

06/30/1995

State

IL

Specialty/Qualifier

General Practice Residency

Ever Disciplined

N

LastModifiedDate

10/12/2005