KIRKEITH LERTSBURAPA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

ACTIVE

Business

First Name

KIRKEITH

Last Name

LERTSBURAPA

Business Name

KIRKEITH LERTSBURAPA

Original Issue Date

07/19/2004

Effective Date

05/30/2023

Expiration Date

07/31/2026

City

JOLIET

State

Zip

60435

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/30/2023