PHIMON ATSAWASUWAN DDS - Dentist License in Illinois | # 136000173

PHIMON ATSAWASUWAN DDS

Business Entity

CANCELLED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000173

License Status

CANCELLED

Business

N

First Name

PHIMON

Last Name

ATSAWASUWAN

Suffix

DDS

Business Name

PHIMON ATSAWASUWAN DDS

Original Issue Date

07/26/2011

Effective Date

07/26/2011

Expiration Date

07/01/2014

State

IL

Ever Disciplined

N

LastModifiedDate

03/13/2015