MARY THUY PHAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036097113

License Status

NOT RENEWED

Business

First Name

MARY

Middle

THUY

Last Name

PHAM

Suffix

Business Name

MARY THUY PHAM MD

Original Issue Date

12/17/1997

Effective Date

06/09/2014

Expiration Date

07/31/2017

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Ever Disciplined

LastModifiedDate

11/01/2017