GWENDOLYN PHAN FOSTER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****68

License Status

NOT RENEWED

Business

First Name

GWENDOLYN

Middle

PHAN

Last Name

FOSTER

Suffix

DDS

Business Name

GWENDOLYN PHAN FOSTER DDS

Original Issue Date

10/14/1998

Effective Date

10/14/1998

Expiration Date

09/30/2002

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005