WANNAPHA PETCHKRUA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036094852

License Status

INACTIVE

Business

First Name

WANNAPHA

Last Name

PETCHKRUA

Suffix

Business Name

WANNAPHA PETCHKRUA MD

Original Issue Date

03/01/1997

Effective Date

03/01/1997

Expiration Date

07/31/1999

City

FOREST PARK

State

Zip

60130

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006