KANIT TANTISIRIVIT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054798

License Status

NOT RENEWED

Business

First Name

KANIT

Last Name

TANTISIRIVIT

Suffix

Business Name

KANIT TANTISIRIVIT MD

Original Issue Date

06/30/1977

Effective Date

06/30/1977

City

EVANSTON

State

Zip

60101

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006