PRAPHAN KITISIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

PRAPHAN

Last Name

KITISIN

Suffix

Business Name

PRAPHAN KITISIN MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

HAZEL CREST

State

Zip

60477

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006