TIRDKIAT SOMBUN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

First Name

TIRDKIAT

Last Name

SOMBUN

Suffix

Business Name

TIRDKIAT SOMBUN MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1990

City

MENDOTA

State

Zip

61342

County

LA SALLE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011