JONATHAN PHEN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019034133

License Status

ACTIVE

Business

First Name

JONATHAN

Last Name

PHEN

Business Name

JONATHAN PHEN

Original Issue Date

04/05/2023

Effective Date

07/22/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

01/26/2026