MATTHEW JOHN PHAN DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****05

License Status

ACTIVE

Business

Title

DDS

First Name

MATTHEW

Middle

JOHN

Last Name

PHAN

Business Name

MATTHEW JOHN PHAN DDS

Original Issue Date

08/23/2019

Effective Date

09/30/2024

Expiration Date

09/30/2027

City

ROSELLE

State

Zip

60172

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/30/2024