VITHIDA SUEBLINVONG Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

ACTIVE

Business

First Name

VITHIDA

Last Name

SUEBLINVONG

Business Name

VITHIDA SUEBLINVONG

Original Issue Date

05/14/1999

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60661

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023