TRI COLIN CONG TRAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****32

License Status

NOT RENEWED

Business

First Name

TRI

Middle

COLIN CONG

Last Name

TRAN

Business Name

TRI COLIN CONG TRAN

Original Issue Date

09/28/2015

Effective Date

02/13/2020

Expiration Date

03/01/2022

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2022