KEITH KHUONG THOI NGUYEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

NOT RENEWED

Business

First Name

KEITH KHUONG

Middle

THOI

Last Name

NGUYEN

Suffix

DDS

Business Name

KEITH KHUONG THOI NGUYEN DDS

Original Issue Date

08/09/2002

Effective Date

08/09/2002

Expiration Date

09/30/2004

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005