PONG LAITEERAPONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036053201

License Status

NOT RENEWED

Business

First Name

PONG

Last Name

LAITEERAPONG

Suffix

Business Name

PONG LAITEERAPONG MD

Original Issue Date

08/19/1976

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

WILMETTE

State

Zip

60091

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021