NOEL M PHAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

Title

First Name

NOEL

Middle

Last Name

PHAN

Business Name

NOEL M PHAN MD

Original Issue Date

12/19/2023

Effective Date

12/19/2023

Expiration Date

07/31/2026

City

CARBONDALE

State

Zip

62901

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/19/2023