PEI'EN FAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061920

License Status

CANCELLED

Business

First Name

PEI'EN

Last Name

FAN

Suffix

Business Name

PEI'EN FAN MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2016

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

05/15/2015