ALISSARA GENA NIMSUWAN DMD - Dentist License in Illinois | # 019030715

ALISSARA GENA NIMSUWAN DMD

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019030715

License Status

NOT RENEWED

Business

N

Title

DMD

First Name

ALISSARA

Middle

GENA

Last Name

NIMSUWAN

Business Name

ALISSARA GENA NIMSUWAN DMD

Original Issue Date

06/15/2016

Effective Date

06/15/2016

Expiration Date

09/30/2018

State

IL

Ever Disciplined

N

LastModifiedDate

10/31/2018