THERESA PHAM DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****11

License Status

ACTIVE

Business

Title

DDS

First Name

THERESA

Last Name

PHAM

Business Name

THERESA PHAM DDS

Original Issue Date

09/26/2011

Effective Date

06/13/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

06/13/2024