RICHARD W CHAN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125027589

License Status

EXPIRED

Business

First Name

RICHARD

Middle

Last Name

CHAN

Business Name

RICHARD W CHAN

Original Issue Date

11/21/1991

Effective Date

11/21/1991

Expiration Date

11/30/1994

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006