Phennatda Polpornvitoon Dmd

License

Licensed by

Illinois Department of Financial and Professional Regulation

License number

018002156

Status

Expired

First issued

June 22, 2020

Expired

June 30, 2021

License holder

Phennatda Polpornvitoon

Entity type

Individual

Classifications

• Temporary Dental Training License Dental

More from the license record

Specialty

Oral and Maxillofacial Surgery

Current term began

07/01/2020

Other Illinois licenses under this name

• IL
  Phennatda Polpornvitoon Dmd

  License 019032839 · Phennatda Polpornvitoon

  Licensed Dentist (Dental)
  Expired

  Chicago, IL

  Expired Jan 31, 2022
• IL
  Phennatda Polpornvitoon Dmd

  License 31*****86 · Phennatda Polpornvitoon

  Licensed Dentist Controlled Substance (Dental)
  Expired

  Chicago, IL

  Expired Jan 31, 2022

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