TIFFANY Y CHANG - Medical Doctor License in Illinois | # 125044425

TIFFANY Y CHANG

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044425

License Status

CANCELLED

Business

N

First Name

TIFFANY

Middle

Y

Last Name

CHANG

Business Name

TIFFANY Y CHANG

Original Issue Date

06/24/2002

Effective Date

06/24/2002

Expiration Date

06/23/2005

State

IL

Specialty/Qualifier

Pathology

Ever Disciplined

N

LastModifiedDate

09/22/2006