LOAN THANH NGUYEN DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****00

License Status

ACTIVE

Business

First Name

LOAN

Middle

THANH

Last Name

NGUYEN

Suffix

DMD

Business Name

LOAN THANH NGUYEN DMD

Original Issue Date

10/14/1999

Effective Date

05/04/2024

Expiration Date

09/30/2027

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/04/2024