MARY R PHAM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019028182

License Status

NOT RENEWED

Business

Title

DDS

First Name

MARY

Middle

Last Name

PHAM

Business Name

MARY R PHAM DDS

Original Issue Date

12/29/2009

Effective Date

12/29/2009

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2012