BINH AN PHUONG PHAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

CANCELLED

Business

Title

First Name

BINH AN

Middle

PHUONG

Last Name

PHAN

Business Name

BINH AN PHUONG PHAN MD

Original Issue Date

08/15/2008

Effective Date

06/24/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014