SUCHADA KONGKIATKAMON - Dentist License in Illinois | # 018001668

SUCHADA KONGKIATKAMON

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001668

License Status

EXPIRED

Business

N

First Name

SUCHADA

Last Name

KONGKIATKAMON

Business Name

SUCHADA KONGKIATKAMON

Original Issue Date

10/22/2007

Effective Date

08/01/2008

Expiration Date

06/30/2011

State

IL

Specialty/Qualifier

Prosthodontics

Ever Disciplined

N

LastModifiedDate

07/19/2011