PHOLAPHAT C INBORIBOON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

ACTIVE

Business

Title

First Name

PHOLAPHAT

Middle

Last Name

INBORIBOON

Business Name

PHOLAPHAT C INBORIBOON MD

Original Issue Date

05/12/2006

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023