WIMOL A MITRAKUL Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

ACTIVE

Business

First Name

WIMOL A

Last Name

MITRAKUL

Business Name

WIMOL A MITRAKUL

Original Issue Date

07/22/2004

Effective Date

05/20/2023

Expiration Date

07/31/2026

City

DOWNERS GROVE

State

Zip

60515

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/20/2023