PHUONGMAI JENNIFER THI VU MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

NOT RENEWED

Business

Title

First Name

PHUONGMAI JENNIFER

Middle

THI

Last Name

Business Name

PHUONGMAI JENNIFER THI VU MD

Original Issue Date

04/22/2015

Effective Date

04/22/2015

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017