SAWAT PHRUTTITUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

NOT RENEWED

Business

First Name

SAWAT

Last Name

PHRUTTITUM

Suffix

Business Name

SAWAT PHRUTTITUM MD

Original Issue Date

05/07/1991

Effective Date

05/07/1991

Expiration Date

07/31/1993

City

ANNA

State

Zip

62906

County

UNION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006