LONG P PHAM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019027905

License Status

NOT RENEWED

Business

First Name

LONG

Middle

Last Name

PHAM

Business Name

LONG P PHAM

Original Issue Date

05/12/2009

Effective Date

06/19/2018

Expiration Date

01/31/2022

City

CAROL STREAM

State

Zip

60188

County

DUPAGE

Ever Disciplined

LastModifiedDate

05/09/2022