KHEMAPORN LERTDETKAJORN MD - Medical Doctor License in Illinois | # 125071611

KHEMAPORN LERTDETKAJORN MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071611

License Status

EXPIRED

Business

N

Title

MD

First Name

KHEMAPORN

Last Name

LERTDETKAJORN

Business Name

KHEMAPORN LERTDETKAJORN MD

Original Issue Date

06/27/2018

Effective Date

06/27/2018

Expiration Date

06/26/2021

City

CHICAGO

State

IL

Zip

60640

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

10/11/2022