NATAWADEE PRASERTPHON YOUNG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

First Name

NATAWADEE

Middle

PRASERTPHON

Last Name

YOUNG

Suffix

Business Name

NATAWADEE PRASERTPHON YOUNG MD

Original Issue Date

07/07/1998

Effective Date

07/07/1998

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006