ANTHONY CALVIN PHAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076215

License Status

CANCELLED

Business

Title

First Name

ANTHONY

Middle

CALVIN

Last Name

PHAN

Business Name

ANTHONY CALVIN PHAN MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2023

City

CHICAGO

State

Zip

60608

Specialty/Qualifier

Physical Medicine and Rehabilitation

Ever Disciplined

LastModifiedDate

05/05/2020