JEFF V WONGSKHALUANG Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

First Name

JEFF

Middle

Last Name

WONGSKHALUANG

Business Name

JEFF V WONGSKHALUANG

Original Issue Date

07/23/2012

Effective Date

07/23/2012

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014