TRUNG Q PHAM Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

ACTIVE

Business

First Name

TRUNG

Middle

Last Name

PHAM

Business Name

TRUNG Q PHAM

Original Issue Date

04/02/2020

Effective Date

06/20/2023

Expiration Date

07/31/2026

City

TUBA CITY

State

Zip

86045

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/20/2023