SOMSUPHA KANJANAUTHAI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

NOT RENEWED

Business

Title

First Name

SOMSUPHA

Last Name

KANJANAUTHAI

Business Name

SOMSUPHA KANJANAUTHAI MD

Original Issue Date

08/15/2014

Effective Date

08/15/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017