CHANTRI TRINH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

CANCELLED

Business

First Name

CHANTRI

Last Name

TRINH

Suffix

Business Name

CHANTRI TRINH MD

Original Issue Date

06/01/2004

Effective Date

06/01/2004

Expiration Date

07/31/2005

City

GLEN CARBON

State

Zip

62034

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006