DANIEL THANH PHONG TRUONG Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007403

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

THANH PHONG

Last Name

TRUONG

Business Name

DANIEL THANH PHONG TRUONG

Original Issue Date

10/21/2019

Effective Date

10/21/2019

Expiration Date

03/01/2020

City

OKLAHOMA CITY

State

Zip

73170

Ever Disciplined

LastModifiedDate

11/24/2020