NHUNG T N PHAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001522

License Status

NOT RENEWED

Business

First Name

NHUNG

Middle

T N

Last Name

PHAN

Business Name

NHUNG T N PHAN

Original Issue Date

10/08/2004

Effective Date

10/08/2004

Expiration Date

09/21/2005

City

COLUMBIA

State

Zip

29210

County

SOUTH CAROLINA

Specialty/Qualifier

Advanced General Dentistry

Ever Disciplined

LastModifiedDate

10/12/2005