AMY SUPORN ASANDRA MD - Medical Doctor License in Illinois | # 125053163

AMY SUPORN ASANDRA MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053163

License Status

EXPIRED

Business

N

First Name

AMY

Middle

SUPORN

Last Name

ASANDRA

Suffix

MD

Business Name

AMY SUPORN ASANDRA MD

Original Issue Date

06/23/2007

Effective Date

06/23/2007

Expiration Date

06/22/2008

City

CHICAGO

State

IL

Zip

60631

County

COOK

Specialty/Qualifier

Transitional Year

Ever Disciplined

N

LastModifiedDate

06/26/2008