JONATHAN H FANG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059715

License Status

CANCELLED

Business

Title

First Name

JONATHAN

Middle

Last Name

FANG

Business Name

JONATHAN H FANG MD

Original Issue Date

06/27/2011

Effective Date

06/27/2011

Expiration Date

06/26/2014

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/06/2011