EKAMOL TANTISATTAMO MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065368

License Status

EXPIRED

Business

Title

First Name

EKAMOL

Last Name

TANTISATTAMO

Business Name

EKAMOL TANTISATTAMO MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Renal Transplant

Ever Disciplined

LastModifiedDate

09/04/2015