PHILLIP THAMRONG SUWAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055461

License Status

CANCELLED

Business

Title

First Name

PHILLIP

Middle

THAMRONG

Last Name

SUWAN

Business Name

PHILLIP THAMRONG SUWAN MD

Original Issue Date

06/27/2011

Effective Date

06/27/2011

Expiration Date

06/26/2013

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

05/02/2011