LILY PHOUIKHAM - Medical Doctor License in Illinois | # 125057504

LILY PHOUIKHAM

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057504

License Status

CANCELLED

Business

N

First Name

LILY

Last Name

PHOUIKHAM

Business Name

LILY PHOUIKHAM

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2015

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

03/24/2014