PENG SITSADAPHONE PHETCHAMPHONE DC Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED CHIROPRACTIC PHYSICIAN

License Number

038010281

License Status

ACTIVE

Business

First Name

PENG

Middle

SITSADAPHONE

Last Name

PHETCHAMPHONE

Suffix

Business Name

PENG SITSADAPHONE PHETCHAMPHONE DC

Original Issue Date

11/16/2004

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

07/27/2023