SUMANAS WANANT JORDAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

ACTIVE

Business

First Name

SUMANAS

Middle

WANANT

Last Name

JORDAN

Suffix

Business Name

SUMANAS WANANT JORDAN MD

Original Issue Date

06/18/2018

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023