DAVID DUNG PHAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

ACTIVE

Business

Title

First Name

DAVID

Middle

DUNG

Last Name

PHAM

Business Name

DAVID DUNG PHAM MD

Original Issue Date

04/19/2019

Effective Date

05/05/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/05/2023