KEVIN YEN FAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****05

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

YEN

Last Name

FAN

Suffix

DDS

Business Name

KEVIN YEN FAN DDS

Original Issue Date

03/06/2012

Effective Date

08/20/2018

Expiration Date

01/31/2022

City

MONTEREY PARK

State

Zip

91754

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/09/2022