MONTHA SUPHANGUL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036121855

License Status

ACTIVE

Business

First Name

MONTHA

Last Name

SUPHANGUL

Suffix

Business Name

MONTHA SUPHANGUL MD

Original Issue Date

08/26/2008

Effective Date

04/29/2023

Expiration Date

07/31/2026

City

EVANSTON

State

Zip

60202

County

COOK

Ever Disciplined

LastModifiedDate

04/29/2023