TIPSUDA JUNSANTO-BAHRI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036095028

License Status

NOT RENEWED

Business

Title

First Name

TIPSUDA

Last Name

JUNSANTO-BAHRI

Business Name

TIPSUDA JUNSANTO-BAHRI MD

Original Issue Date

03/13/1997

Effective Date

07/25/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017