PHIMON ATSAWASUWAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****18

License Status

NOT RENEWED

Business

First Name

PHIMON

Last Name

ATSAWASUWAN

Suffix

DDS

Business Name

PHIMON ATSAWASUWAN DDS

Original Issue Date

06/12/2019

Effective Date

06/12/2019

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60605

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022