GUNTIPPAR SOONTAREE PRATUMNGERN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039659

License Status

EXPIRED

Business

First Name

GUNTIPPAR

Middle

SOONTAREE

Last Name

PRATUMNGERN

Suffix

Business Name

GUNTIPPAR SOONTAREE PRATUMNGERN DO

Original Issue Date

06/24/1999

Effective Date

06/24/1999

Expiration Date

06/23/2002

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006