DAVE QUANG PHAM DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****55

License Status

NOT RENEWED

Business

First Name

DAVE QUANG

Last Name

PHAM

Suffix

DPM

Business Name

DAVE QUANG PHAM DPM

Original Issue Date

09/30/2009

Effective Date

11/17/2014

Expiration Date

01/31/2017

City

BELLEVILLE

State

Zip

62223

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/27/2017