ANNIE PHUNG DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078177

License Status

EXPIRED

Business

Title

First Name

ANNIE

Last Name

PHUNG

Business Name

ANNIE PHUNG DO

Original Issue Date

06/23/2021

Effective Date

06/23/2021

Expiration Date

06/22/2024

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/30/2024