ATTAPOOM SUSUPAUS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060733

License Status

EXPIRED

Business

Title

First Name

ATTAPOOM

Last Name

SUSUPAUS

Business Name

ATTAPOOM SUSUPAUS MD

Original Issue Date

11/15/2011

Effective Date

11/15/2011

Expiration Date

11/14/2012

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Adult Cardiac Surgery

Ever Disciplined

LastModifiedDate

01/11/2013