SINEE DISTHABANCHONG Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033672

License Status

EXPIRED

Business

First Name

SINEE

Last Name

DISTHABANCHONG

Business Name

SINEE DISTHABANCHONG

Original Issue Date

06/29/1995

Effective Date

06/29/1995

Expiration Date

06/27/1998

City

CHICAGO

State

Zip

60640

County

COOK

Ever Disciplined

LastModifiedDate

10/15/2012