SAOWARUT KITTIMONGCOLPORN - Medical Doctor License in Illinois | # 125032803

SAOWARUT KITTIMONGCOLPORN

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032803

License Status

EXPIRED

Business

N

First Name

SAOWARUT

Last Name

KITTIMONGCOLPORN

Business Name

SAOWARUT KITTIMONGCOLPORN

Original Issue Date

05/30/1995

Effective Date

05/30/1995

Expiration Date

06/30/1998

City

URBANA

State

IL

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006