WIPHADA P INGKANISORN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036097776

License Status

NOT RENEWED

Business

First Name

WIPHADA

Middle

Last Name

INGKANISORN

Suffix

Business Name

WIPHADA P INGKANISORN MD

Original Issue Date

05/01/1998

Effective Date

05/01/1998

Expiration Date

07/31/2005

City

DES PLAINES

State

Zip

60016

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006