SUCHADA KONGKIATKAMON Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001668

License Status

EXPIRED

Business

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

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Prosthodontics

Ever Disciplined

LastModifiedDate

07/19/2011