CHIRAVUDH SAWETAWAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

First Name

CHIRAVUDH

Last Name

SAWETAWAN

Suffix

Business Name

CHIRAVUDH SAWETAWAN MD

Original Issue Date

08/09/1996

Effective Date

06/12/2017

Expiration Date

09/30/2020

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021