GWENDOLYN PHAN FOSTER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****93

License Status

NOT RENEWED

Business

First Name

GWENDOLYN

Middle

PHAN

Last Name

FOSTER

Suffix

DDS

Business Name

GWENDOLYN PHAN FOSTER DDS

Original Issue Date

02/21/2008

Effective Date

07/14/2009

Expiration Date

09/30/2012

City

GURNEE

State

Zip

60031

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012