Phennatda Polpornvitoon Dmd

License

Licensed by

Illinois Department of Financial and Professional Regulation

License number

019032839

Status

Expired (Not Renewed)

First issued

July 27, 2020

Expired

January 31, 2022

License holder

Phennatda Polpornvitoon

Entity type

Individual

Classifications

• Licensed Dentist (Dental) Dental

More from the license record

Current term began

07/27/2020

Other Illinois licenses under this name

• IL
  Phennatda Polpornvitoon Dmd

  License 018002156 · Phennatda Polpornvitoon

  Temporary Dental Training License
  Expired

  Chicago, IL

  Expired Jun 30, 2021
• 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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