CAMTHU MINH PHAM OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****01

License Status

NOT RENEWED

Business

First Name

CAMTHU

Middle

MINH

Last Name

PHAM

Suffix

Business Name

CAMTHU MINH PHAM OD

Original Issue Date

02/02/2001

Effective Date

03/08/2004

Expiration Date

03/31/2006

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

Practitioner

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/11/2006