VIVIAN WAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125080225

License Status

CANCELLED

Business

Title

First Name

VIVIAN

Last Name

WAN

Business Name

VIVIAN WAN MD

Original Issue Date

06/23/2022

Effective Date

06/23/2022

Expiration Date

06/22/2025

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

02/07/2025