ANUTTARA PATHOMVANICH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125029215

License Status

EXPIRED

Business

First Name

ANUTTARA

Last Name

PATHOMVANICH

Business Name

ANUTTARA PATHOMVANICH

Original Issue Date

03/08/1993

Effective Date

03/08/1993

Expiration Date

06/23/1996

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006