MAKHAWADEE PONGRUANGPORN MD - Medical Doctor License in Illinois | # 125052433

MAKHAWADEE PONGRUANGPORN MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052433

License Status

EXPIRED

Business

N

First Name

MAKHAWADEE

Last Name

PONGRUANGPORN

Suffix

MD

Business Name

MAKHAWADEE PONGRUANGPORN MD

Original Issue Date

06/24/2007

Effective Date

06/24/2007

Expiration Date

06/23/2010

City

EVANSTON

State

IL

Zip

60202

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

06/24/2010