MICHAELIA VASILIA FOSSES VUONG DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069974

License Status

CANCELLED

Business

Title

First Name

MICHAELIA

Middle

VASILIA

Last Name

FOSSES VUONG

Business Name

MICHAELIA VASILIA FOSSES VUONG DO

Original Issue Date

06/26/2017

Effective Date

06/26/2017

Expiration Date

06/25/2020

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

04/28/2017