MELISSA JIAYU FANG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125079211

License Status

CANCELLED

Business

Title

First Name

MELISSA

Middle

JIAYU

Last Name

FANG

Business Name

MELISSA JIAYU FANG MD

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2025

City

MAYWOOD

State

Zip

60153

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

03/22/2022