ROME JUTABHA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

First Name

ROME

Last Name

JUTABHA

Suffix

Business Name

ROME JUTABHA MD

Original Issue Date

01/13/1989

Effective Date

01/13/1989

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

09/26/2006