KANRAMON WATTHANASUNTORN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

ACTIVE

Business

Title

First Name

KANRAMON

Last Name

WATTHANASUNTORN

Business Name

KANRAMON WATTHANASUNTORN MD

Original Issue Date

02/11/2020

Effective Date

04/19/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60653

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/19/2023