CHAIYUT CHAROENTUM Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035240

License Status

EXPIRED

Business

First Name

CHAIYUT

Last Name

CHAROENTUM

Business Name

CHAIYUT CHAROENTUM

Original Issue Date

06/25/1996

Effective Date

06/25/1996

Expiration Date

06/23/1999

City

CHICAGO

State

Zip

60640

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006