PITTAYA VEJVIBOONSOM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

NOT RENEWED

Business

First Name

PITTAYA

Last Name

VEJVIBOONSOM

Suffix

Business Name

PITTAYA VEJVIBOONSOM MD

Original Issue Date

08/24/1981

Effective Date

08/24/1981

Expiration Date

07/31/1984

City

GLENVIEW

State

Zip

60025

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006