WATCHARIYAPORN THASAI - Dentist License in Illinois | # 31*****80

WATCHARIYAPORN THASAI

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****80

License Status

ACTIVE

Business

N

First Name

WATCHARIYAPORN

Last Name

THASAI

Business Name

WATCHARIYAPORN THASAI

Original Issue Date

11/10/2025

Effective Date

11/10/2025

Expiration Date

09/30/2027

City

MORTON GROVE

State

IL

Zip

60053

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

11/10/2025