PANOM PHOUNGCHERDCHOO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

ACTIVE

Business

First Name

PANOM

Last Name

PHOUNGCHERDCHOO

Suffix

Business Name

PANOM PHOUNGCHERDCHOO MD

Original Issue Date

01/01/1997

Effective Date

08/03/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/03/2023