VIVAN NGUYEN TRAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

Title

First Name

VIVAN

Middle

NGUYEN

Last Name

TRAN

Business Name

VIVAN NGUYEN TRAN MD

Original Issue Date

11/12/2009

Effective Date

06/06/2011

Expiration Date

07/31/2014

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014