TEERA PITTAYATHIKHUN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

First Name

TEERA

Last Name

PITTAYATHIKHUN

Business Name

TEERA PITTAYATHIKHUN

Original Issue Date

01/23/1984

Effective Date

06/16/2008

Expiration Date

07/31/2011

City

SPARTA

State

Zip

62286

County

RANDOLPH

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011