KANIT TANTISIRIVIT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

KANIT

Last Name

TANTISIRIVIT

Suffix

Business Name

KANIT TANTISIRIVIT MD

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

CHICAGO

State

Zip

60645

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006