DONG-PHUONG T LY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019025995

License Status

NOT RENEWED

Business

First Name

DONG-PHUONG

Middle

Last Name

Business Name

DONG-PHUONG T LY

Original Issue Date

10/09/2002

Effective Date

10/09/2002

Expiration Date

09/30/2004

City

FAIRFAX

State

Zip

22032

County

VIRGINIA

Ever Disciplined

LastModifiedDate

10/17/2005