PUANG TANTAMJARIK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036048128

License Status

NOT RENEWED

Business

First Name

PUANG

Last Name

TANTAMJARIK

Suffix

Business Name

PUANG TANTAMJARIK MD

Original Issue Date

08/23/1973

Effective Date

08/23/1973

City

HOMEWOOD

State

Zip

60430

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006