PENPORN VONGSVIVUT RECK MD - Medical Doctor License in Illinois | # 036115823

PENPORN VONGSVIVUT RECK MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036115823

License Status

NOT RENEWED

Business

N

First Name

PENPORN

Middle

VONGSVIVUT

Last Name

RECK

Suffix

MD

Business Name

PENPORN VONGSVIVUT RECK MD

Original Issue Date

05/02/2006

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CHICAGO

State

IL

Zip

60612

County

COOK

Ever Disciplined

N

LastModifiedDate

11/06/2008