KANOKPORN MONGKOLRATTANOTHAI - Medical Doctor License in Illinois | # 125042143

KANOKPORN MONGKOLRATTANOTHAI

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042143

License Status

CANCELLED

Business

N

First Name

KANOKPORN

Last Name

MONGKOLRATTANOTHAI

Business Name

KANOKPORN MONGKOLRATTANOTHAI

Original Issue Date

10/01/2000

Effective Date

10/01/2000

Expiration Date

09/30/2005

City

CHICAGO

State

IL

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

N

LastModifiedDate

09/22/2006