LERTLUCK NUTAKUL MD Medical Doctor License verification

Business Entity

INOPERATIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

INOPERATIVE

Business

First Name

LERTLUCK

Last Name

NUTAKUL

Suffix

Business Name

LERTLUCK NUTAKUL MD

Original Issue Date

11/24/1992

Effective Date

11/24/1992

Expiration Date

07/31/1993

City

BELLEVILLE

State

Zip

62225

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006