VIVIAN PHUONG NGUYEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****08

License Status

NOT RENEWED

Business

First Name

VIVIAN

Middle

PHUONG

Last Name

NGUYEN

Business Name

VIVIAN PHUONG NGUYEN

Original Issue Date

07/30/2002

Effective Date

10/01/2021

Expiration Date

09/30/2024

City

CHICAGO

State

Zip

60639

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025