VIJAK SIRIWONGSE AYASANONDA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

VIJAK

Middle

SIRIWONGSE

Last Name

AYASANONDA

Suffix

Business Name

VIJAK SIRIWONGSE AYASANONDA MD

Original Issue Date

12/03/2004

Effective Date

12/03/2004

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008