SUMANAS WANANT JORDAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058784

License Status

CANCELLED

Business

First Name

SUMANAS

Middle

WANANT

Last Name

JORDAN

Suffix

Business Name

SUMANAS WANANT JORDAN MD

Original Issue Date

06/23/2014

Effective Date

06/23/2014

Expiration Date

06/22/2016

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Plastic Surgery

Ever Disciplined

LastModifiedDate

05/21/2014