BRIAN MAN CHAN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075035

License Status

CANCELLED

Business

Title

First Name

BRIAN

Middle

MAN

Last Name

CHAN

Business Name

BRIAN MAN CHAN DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

NORMAL

State

Zip

61761

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/14/2019