WIPHADA P INGKANISORN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032997

License Status

EXPIRED

Business

First Name

WIPHADA

Middle

Last Name

INGKANISORN

Suffix

Business Name

WIPHADA P INGKANISORN MD

Original Issue Date

06/05/1995

Effective Date

06/05/1995

Expiration Date

06/30/1998

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006