VAN TUONG PHAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075228

License Status

CANCELLED

Business

Title

First Name

VAN

Middle

TUONG

Last Name

PHAN

Business Name

VAN TUONG PHAN MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

05/02/2019