SRIVIMOL C TANTAMJARIK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046365

License Status

NOT RENEWED

Business

First Name

SRIVIMOL C

Last Name

TANTAMJARIK

Suffix

Business Name

SRIVIMOL C TANTAMJARIK MD

Original Issue Date

08/17/1972

Effective Date

08/17/1972

City

HOMEWOOD

State

Zip

60430

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006