PHONEKEO KHAMVANTHONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

Title

First Name

PHONEKEO

Last Name

KHAMVANTHONG

Business Name

PHONEKEO KHAMVANTHONG MD

Original Issue Date

01/15/2014

Effective Date

01/15/2014

Expiration Date

07/31/2014

City

AURORA

State

Zip

60504

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014