PONGPEERA TAYTAWAT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059068

License Status

EXPIRED

Business

First Name

PONGPEERA

Last Name

TAYTAWAT

Suffix

Business Name

PONGPEERA TAYTAWAT MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

07/27/2014

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

02/06/2017

Case Number

2014006601

Action

Suspension

Discipline Start Date

05/12/2015

Discipline End Date

01/30/2017

Discipline Reason

due to unprofessional conduct and the use of a false, fraudulent, or deceptive statement.