MALEEWAN KITCHAROENSAKKUL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

ACTIVE

Business

Title

First Name

MALEEWAN

Last Name

KITCHAROENSAKKUL

Business Name

MALEEWAN KITCHAROENSAKKUL MD

Original Issue Date

12/11/2020

Effective Date

05/08/2023

Expiration Date

07/31/2026

City

SHILOH

State

Zip

62269

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/08/2023