LISA PORAPAIBOON HANSON DDS - Dentist License in Illinois | # 137000755

LISA PORAPAIBOON HANSON DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000755

License Status

NOT RENEWED

Business

N

Title

DDS

First Name

LISA

Middle

PORAPAIBOON

Last Name

HANSON

Business Name

LISA PORAPAIBOON HANSON DDS

Original Issue Date

07/13/2009

Effective Date

09/18/2018

Expiration Date

01/31/2022

State

IL

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

N

LastModifiedDate

05/09/2022