ORNSUDA LERTBANNAPHONG MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054548

License Status

EXPIRED

Business

First Name

ORNSUDA

Last Name

LERTBANNAPHONG

Suffix

Business Name

ORNSUDA LERTBANNAPHONG MD

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

07/19/2011