SAHAWAT TANTIKITTICHAIKUL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

Title

First Name

SAHAWAT

Last Name

TANTIKITTICHAIKUL

Business Name

SAHAWAT TANTIKITTICHAIKUL MD

Original Issue Date

04/06/2021

Effective Date

04/06/2021

Expiration Date

07/31/2023

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023