ALLEN PONDEVIDA MOMONGAN DDS - Dentist License in Illinois | # 137000393

ALLEN PONDEVIDA MOMONGAN DDS

Business Entity

INACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000393

License Status

INACTIVE

Business

N

First Name

ALLEN PONDEVIDA

Last Name

MOMONGAN

Suffix

DDS

Business Name

ALLEN PONDEVIDA MOMONGAN DDS

Original Issue Date

11/21/1995

Effective Date

11/21/1995

Expiration Date

09/30/1998

State

IL

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

N

LastModifiedDate

10/13/2005