PHUOC THANH VUONG DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

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

08/04/2009

Expiration Date

09/30/2012

City

OSWEGO

State

Zip

60543

County

KENDALL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012