SONG KEITH PIYAKA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

NOT RENEWED

Business

First Name

SONG KEITH

Last Name

PIYAKA

Suffix

Business Name

SONG KEITH PIYAKA MD

Original Issue Date

01/01/1997

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021