DEJA ANGSURAT MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036045930

License Status

INACTIVE

Business

First Name

DEJA

Last Name

ANGSURAT

Suffix

Business Name

DEJA ANGSURAT MD

Original Issue Date

07/31/1972

Effective Date

07/31/1972

Expiration Date

07/31/2005

City

DOWNERS GROVE

State

Zip

60516

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/09/2006