JIRAVUD CHANVITAYAPONGS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000167

License Status

EXPIRED

Business

First Name

JIRAVUD

Last Name

CHANVITAYAPONGS

Suffix

Business Name

JIRAVUD CHANVITAYAPONGS MD

Original Issue Date

10/01/2002

Effective Date

10/01/2002

Expiration Date

03/31/2003

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/25/2006