JUBILEE TAN PHAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

ACTIVE

Business

Title

First Name

JUBILEE

Middle

TAN

Last Name

PHAN

Business Name

JUBILEE TAN PHAN MD

Original Issue Date

07/11/2018

Effective Date

07/08/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61615

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/08/2023