NATAKOM N CHULAMORKODT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

NATAKOM

Middle

Last Name

CHULAMORKODT

Suffix

Business Name

NATAKOM N CHULAMORKODT MD

Original Issue Date

10/24/2006

Effective Date

06/16/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011