PANTILA VANICHAKARN BATEMAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

ACTIVE

Business

Title

First Name

PANTILA

Middle

VANICHAKARN

Last Name

BATEMAN

Business Name

PANTILA VANICHAKARN BATEMAN MD

Original Issue Date

09/24/2022

Effective Date

06/20/2023

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/20/2023