License holder summary

PHAM, BAO TIEN, DO is a Medical - Physician licensed to practice in Georgia. The address on file for PHAM, BAO TIEN, DO is 1560 KINGSLEY AVE, ORANGE PARK 32073. This doctor license is not current. The license was granted 03/02/2001 and expired on 12/31/2003.

Georgia

Composite Medical Board

PHAM, BAO TIEN, DO
Medical - Physician
License number
049815
Date granted
03/02/2001
Date expires
12/31/2003
Class
Medical - Physician
Status
Lapsed
Address
1560 KINGSLEY AVE
georgiadoctors.net
ID 38072681
LAST UPDATED 2021-06-10 02:54:12 UTC

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