KEITH LONGANH PHAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

ACTIVE

Business

First Name

KEITH

Middle

LONGANH

Last Name

PHAM

Suffix

Business Name

KEITH LONGANH PHAM MD

Original Issue Date

02/01/2018

Effective Date

07/25/2023

Expiration Date

07/31/2026

City

STERLING

State

Zip

61081

County

WHITESIDE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/25/2023