PHYLLIS C CHANG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045817

License Status

CANCELLED

Business

Title

First Name

PHYLLIS

Middle

Last Name

CHANG

Business Name

PHYLLIS C CHANG MD

Original Issue Date

06/24/2003

Effective Date

06/24/2003

Expiration Date

06/23/2007

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006