HA NGUYEN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****16

License Status

ACTIVE

Business

First Name

Last Name

NGUYEN

Business Name

HA NGUYEN

Original Issue Date

08/07/2024

Effective Date

08/07/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61614

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/07/2024