ANNISE KIEU CHUNG DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

ACTIVE

Business

Title

First Name

ANNISE

Middle

KIEU

Last Name

CHUNG

Business Name

ANNISE KIEU CHUNG DO

Original Issue Date

03/30/2021

Effective Date

07/13/2023

Expiration Date

07/31/2026

City

CLEVELAND

State

Zip

44106

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/13/2023