PHIMON ATSAWASUWAN DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000173

License Status

CANCELLED

Business

First Name

PHIMON

Last Name

ATSAWASUWAN

Suffix

DDS

Business Name

PHIMON ATSAWASUWAN DDS

Original Issue Date

07/26/2011

Effective Date

07/26/2011

Expiration Date

07/01/2014

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

03/13/2015