ALISSARA GENA NIMSUWAN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019030715

License Status

NOT RENEWED

Business

Title

DMD

First Name

ALISSARA

Middle

GENA

Last Name

NIMSUWAN

Business Name

ALISSARA GENA NIMSUWAN DMD

Original Issue Date

06/15/2016

Effective Date

06/15/2016

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

10/31/2018