CHAROEN PANUSARN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036045313

License Status

NOT RENEWED

Business

First Name

CHAROEN

Last Name

PANUSARN

Suffix

Business Name

CHAROEN PANUSARN MD

Original Issue Date

02/04/1972

Effective Date

02/04/1972

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006