CHANAVUTH KANITSORAPHAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036159623

License Status

ACTIVE

Business

Title

First Name

CHANAVUTH

Last Name

KANITSORAPHAN

Business Name

CHANAVUTH KANITSORAPHAN MD

Original Issue Date

03/02/2022

Effective Date

05/09/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60605

Ever Disciplined

LastModifiedDate

06/21/2024