SITHIPOL TANTIHACHAI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

NOT RENEWED

Business

First Name

SITHIPOL

Last Name

TANTIHACHAI

Suffix

Business Name

SITHIPOL TANTIHACHAI MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

RANTOUL

State

Zip

61866

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006