QUAN NGUYEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****47

License Status

NOT RENEWED

Business

First Name

QUAN

Last Name

NGUYEN

Suffix

DDS

Business Name

QUAN NGUYEN DDS

Original Issue Date

05/15/1992

Effective Date

05/15/1992

Expiration Date

09/30/1994

City

ROCKFORD

State

Zip

61102

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005