THITAPA PETLERKWONG DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036174075

License Status

ACTIVE

Business

Title

First Name

THITAPA

Last Name

PETLERKWONG

Business Name

THITAPA PETLERKWONG DO

Original Issue Date

03/07/2025

Effective Date

03/07/2025

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61605

Ever Disciplined

LastModifiedDate

02/24/2025