KENNETH K CHAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065913

License Status

CANCELLED

Business

Title

First Name

KENNETH

Middle

Last Name

CHAN

Business Name

KENNETH K CHAN MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

07/18/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/05/2017