PANJAPORN SUPANWANID MD - Medical Doctor License in Illinois | # 125048001

PANJAPORN SUPANWANID MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048001

License Status

CANCELLED

Business

N

First Name

PANJAPORN

Last Name

SUPANWANID

Suffix

MD

Business Name

PANJAPORN SUPANWANID MD

Original Issue Date

06/21/2007

Effective Date

06/21/2007

Expiration Date

06/20/2008

City

CHICAGO

State

IL

Zip

60614

County

COOK

Ever Disciplined

N

LastModifiedDate

04/02/2007