Phennatda Polpornvitoon Dmd

License

Licensed by

Illinois Department of Financial and Professional Regulation

License number

31*****86

Status

Expired (Not Renewed)

First issued

November 5, 2020

Expired

January 31, 2022

License holder

Phennatda Polpornvitoon

Entity type

Individual

Classifications

• Licensed Dentist Controlled Substance (Dental) Dental

More from the license record

Specialty

Practitioner

Controlled substance schedules

II III IV V

Current term began

11/05/2020

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 019032839 · Phennatda Polpornvitoon

  Licensed Dentist (Dental)
  Expired

  Chicago, IL

  Expired Jan 31, 2022

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