PHUOC THANH VUONG DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****71

License Status

NOT RENEWED

Business

First Name

PHUOC

Middle

THANH

Last Name

VUONG

Suffix

DMD

Business Name

PHUOC THANH VUONG DMD

Original Issue Date

09/27/2002

Effective Date

09/27/2002

Expiration Date

09/30/2004

City

CHICAGO

State

Zip

60625

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005