S SUWATANA PONGCHED MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036045385

License Status

INACTIVE

Business

First Name

S SUWATANA

Last Name

PONGCHED

Suffix

Business Name

S SUWATANA PONGCHED MD

Original Issue Date

02/04/1972

Effective Date

06/22/2011

Expiration Date

07/31/2014

City

FOREST PARK

State

Zip

60130

County

COOK

Ever Disciplined

LastModifiedDate

04/08/2014