Khanh Anh Thuy Phan
ExpiredCalifornia license 49187
License
- Licensed by
- Dental Board of California
- License number
- 49187
- Status
- Expired (Delinquent)
- First issued
- November 14, 2001
- Expired
- January 31, 2025
- License holder
- Khanh Anh Thuy Phan
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
629 Fairway View Terrace
Southlake, TX 76092
Southlake, TX 76092
Tarrant County