PATRIN SUPPATKUL KONGKAEOW MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063961

License Status

EXPIRED

Business

First Name

PATRIN

Last Name

SUPPATKUL KONGKAEOW

Suffix

Business Name

PATRIN SUPPATKUL KONGKAEOW MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

LISLE

State

Zip

60532

County

DUPAGE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

08/16/2016