MARY THUY PHAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

MARY

Middle

THUY

Last Name

PHAM

Suffix

Business Name

MARY THUY PHAM MD

Original Issue Date

12/22/1997

Effective Date

06/09/2014

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017