BRITTANY PHAM Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****53

License Status

ACTIVE

Business

First Name

BRITTANY

Last Name

PHAM

Business Name

BRITTANY PHAM

Original Issue Date

06/12/2018

Effective Date

05/29/2024

Expiration Date

09/30/2027

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/29/2024