PHYLLIS CHANG Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

First Name

PHYLLIS

Last Name

CHANG

Business Name

PHYLLIS CHANG

Original Issue Date

07/25/1986

Effective Date

07/25/1986

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006