LANCY MIMI TAN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001366

License Status

EXPIRED

Business

First Name

LANCY

Middle

MIMI

Last Name

TAN

Business Name

LANCY MIMI TAN

Original Issue Date

09/15/2020

Effective Date

09/15/2020

Expiration Date

12/14/2020

City

CHICAGO

State

Zip

60637

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

03/11/2021