ANUSAK SERIRUK Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****78

License Status

NOT RENEWED

Business

First Name

ANUSAK

Last Name

SERIRUK

Business Name

ANUSAK SERIRUK

Original Issue Date

05/13/1996

Effective Date

01/06/2017

Expiration Date

01/31/2019

City

CHICAGO

State

Zip

60625

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/28/2019