NAM THANH PHAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000548

License Status

EXPIRED

Business

Title

First Name

NAM

Middle

THANH

Last Name

PHAN

Business Name

NAM THANH PHAN MD

Original Issue Date

04/16/2019

Effective Date

04/16/2019

Expiration Date

10/15/2019

City

OAK LAWN

State

Zip

60453

Specialty/Qualifier

Pediatric Cardiac Surgery

Ever Disciplined

LastModifiedDate

01/13/2020