PUANGPETH JANTRA 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

PUANGPETH

Last Name

JANTRA

Suffix

Business Name

PUANGPETH JANTRA MD

Original Issue Date

01/01/1997

Effective Date

12/16/2014

Expiration Date

07/31/2017

City

NORTHBROOK

State

Zip

60062

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017