XUANLAN THI PHAN - Dentist License in Illinois | # 018001011

XUANLAN THI PHAN

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001011

License Status

EXPIRED

Business

N

First Name

XUANLAN THI

Last Name

PHAN

Business Name

XUANLAN THI PHAN

Original Issue Date

05/15/1997

Effective Date

05/15/1997

Expiration Date

05/30/2000

State

IL

Specialty/Qualifier

Orthodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005