SOMCHAI SUPAWANICH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046359

License Status

NOT RENEWED

Business

First Name

SOMCHAI

Last Name

SUPAWANICH

Suffix

Business Name

SOMCHAI SUPAWANICH MD

Original Issue Date

08/17/1972

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

GIBSON CITY

State

Zip

60936

County

FORD

Ever Disciplined

LastModifiedDate

11/06/2008