CHANATIP SUKSANG Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034831

License Status

EXPIRED

Business

First Name

CHANATIP

Last Name

SUKSANG

Business Name

CHANATIP SUKSANG

Original Issue Date

06/03/1996

Effective Date

06/03/1996

Expiration Date

06/30/1999

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006