SUPALUCK KANJANAUTHAI MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036120597

License Status

INACTIVE

Business

First Name

SUPALUCK

Last Name

KANJANAUTHAI

Suffix

Business Name

SUPALUCK KANJANAUTHAI MD

Original Issue Date

04/15/2008

Effective Date

05/04/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

10/22/2011