SOMPORN PUANGSUVAN MD - Medical Doctor License in Illinois | # 33*****77

SOMPORN PUANGSUVAN MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

NOT RENEWED

Business

N

First Name

SOMPORN

Last Name

PUANGSUVAN

Suffix

MD

Business Name

SOMPORN PUANGSUVAN MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

ELDORADO

State

IL

Zip

62930

County

SALINE

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

09/26/2006