GOTH KWO FUNG SIU DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019028786

License Status

NOT RENEWED

Business

Title

DMD

First Name

GOTH

Middle

KWO FUNG

Last Name

SIU

Business Name

GOTH KWO FUNG SIU DMD

Original Issue Date

07/19/2011

Effective Date

09/17/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60601

County

COOK

Ever Disciplined

LastModifiedDate

02/08/2016