TANYANAN TANAWUTTIWAT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052300

License Status

EXPIRED

Business

First Name

TANYANAN

Last Name

TANAWUTTIWAT

Suffix

Business Name

TANYANAN TANAWUTTIWAT MD

Original Issue Date

06/24/2007

Effective Date

06/24/2007

Expiration Date

06/23/2010

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/24/2010