JIMMY DUY PHAM DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019034108

License Status

INACTIVE

Business

Title

DDS

First Name

JIMMY

Middle

DUY

Last Name

PHAM

Business Name

JIMMY DUY PHAM DDS

Original Issue Date

03/13/2023

Effective Date

03/13/2023

Expiration Date

09/30/2024

City

GLEN CARBON

State

Zip

62034

County

MADISON

Ever Disciplined

LastModifiedDate

09/23/2024