WANNAPHA PETCHKRUA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034462

License Status

EXPIRED

Business

First Name

WANNAPHA

Last Name

PETCHKRUA

Suffix

Business Name

WANNAPHA PETCHKRUA MD

Original Issue Date

05/20/1996

Effective Date

05/20/1996

Expiration Date

06/30/1999

City

CHICAGO

State

Zip

60608

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006