PHIVU CONG NGUYEN DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

ACTIVE

Business

Title

First Name

PHIVU

Middle

CONG

Last Name

NGUYEN

Business Name

PHIVU CONG NGUYEN DO

Original Issue Date

06/10/2021

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

KANKAKEE

State

Zip

60901

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/13/2023