PHONEKEO KHAMVANTHONG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060699

License Status

CANCELLED

Business

Title

First Name

PHONEKEO

Last Name

KHAMVANTHONG

Business Name

PHONEKEO KHAMVANTHONG MD

Original Issue Date

08/01/2011

Effective Date

08/01/2011

Expiration Date

06/30/2014

City

AURORA

State

Zip

60504

County

DUPAGE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

08/01/2011