POONSRI KEOMUAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

First Name

POONSRI

Last Name

KEOMUAN

Suffix

Business Name

POONSRI KEOMUAN MD

Original Issue Date

01/01/1997

Effective Date

05/30/2017

Expiration Date

09/30/2020

City

LOMBARD

State

Zip

60148

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021