SIRISAK PURIBHAT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

First Name

SIRISAK

Last Name

PURIBHAT

Suffix

Business Name

SIRISAK PURIBHAT MD

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

CHICAGO

State

Zip

60625

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006