PHU SI HUYNH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

ACTIVE

Business

Title

First Name

PHU

Middle

Last Name

HUYNH

Business Name

PHU SI HUYNH MD

Original Issue Date

11/26/2022

Effective Date

07/05/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/05/2023