PHORNPHAT RASAMIMARI Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

ACTIVE

Business

First Name

PHORNPHAT

Last Name

RASAMIMARI

Business Name

PHORNPHAT RASAMIMARI

Original Issue Date

01/10/2006

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023