KHAUNSAVAN VONGPHAKDY Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****23

License Status

ACTIVE

Business

First Name

KHAUNSAVAN

Last Name

VONGPHAKDY

Business Name

KHAUNSAVAN VONGPHAKDY

Original Issue Date

07/08/2024

Effective Date

01/22/2026

Expiration Date

03/01/2028

City

EVANSTON

State

Zip

60201

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/22/2026