CONG THANH LY DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049219

License Status

CANCELLED

Business

First Name

CONG

Middle

THANH

Last Name

Suffix

Business Name

CONG THANH LY DO

Original Issue Date

06/20/2005

Effective Date

06/20/2005

Expiration Date

06/30/2008

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006