PRAPHAN KITISIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036047949

License Status

NOT RENEWED

Business

First Name

PRAPHAN

Last Name

KITISIN

Suffix

Business Name

PRAPHAN KITISIN MD

Original Issue Date

08/23/1973

Effective Date

08/23/1973

City

COUNTRY CLUB HILLS

State

Zip

60477

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006