PRIYASUDA HETRAKUL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125043799

License Status

EXPIRED

Business

First Name

PRIYASUDA

Last Name

HETRAKUL

Suffix

Business Name

PRIYASUDA HETRAKUL MD

Original Issue Date

09/24/2001

Effective Date

09/24/2001

Expiration Date

09/23/2004

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006