VINCE VISITH SOUN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

Title

First Name

VINCE

Middle

VISITH

Last Name

SOUN

Business Name

VINCE VISITH SOUN MD

Original Issue Date

10/10/2013

Effective Date

10/10/2013

Expiration Date

07/31/2014

City

HINSDALE

State

Zip

60521

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014