PANITA CHIEMMONGKOLTIP Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

ACTIVE

Business

First Name

PANITA

Last Name

CHIEMMONGKOLTIP

Business Name

PANITA CHIEMMONGKOLTIP

Original Issue Date

09/28/1998

Effective Date

04/21/2023

Expiration Date

07/31/2026

City

ADDISON

State

Zip

60101

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/21/2023