SON PHONG LE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

ACTIVE

Business

First Name

SON

Middle

PHONG

Last Name

Suffix

Business Name

SON PHONG LE MD

Original Issue Date

06/24/2002

Effective Date

06/02/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/02/2023