PANEEYA SUTABUTRA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033735

License Status

EXPIRED

Business

First Name

PANEEYA

Last Name

SUTABUTRA

Business Name

PANEEYA SUTABUTRA

Original Issue Date

07/03/1995

Effective Date

07/03/1995

Expiration Date

07/16/1998

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006