SIV EANG CHUNG CHHAY Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000240

License Status

EXPIRED

Business

First Name

SIV EANG

Middle

CHUNG

Last Name

CHHAY

Business Name

SIV EANG CHUNG CHHAY

Original Issue Date

01/23/2019

Effective Date

01/23/2019

Expiration Date

01/23/2022

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

11/28/2022