SIRIRAT R BANUCHI 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

SIRIRAT R

Last Name

BANUCHI

Suffix

Business Name

SIRIRAT R BANUCHI MD

Original Issue Date

01/01/1997

Effective Date

05/19/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60630

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017