DUNG TIEN PHAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

ACTIVE

Business

Title

First Name

DUNG

Middle

TIEN

Last Name

PHAM

Business Name

DUNG TIEN PHAM MD

Original Issue Date

03/14/2019

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023