DAN FONG DDS

Business Entity
NOT RENEWED

Dentist

LICENSED DENTIST CONTROLLED SUBSTANCE

31*****59

NOT RENEWED

N

DDS

DAN

FONG

DAN FONG DDS

02/17/1994

02/17/1994

09/30/1994

DES PLAINES

IL

60016

COOK

II III IV V

N

10/13/2005