CHANATIP SUKSANG Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

CANCELLED

Business

First Name

CHANATIP

Last Name

SUKSANG

Business Name

CHANATIP SUKSANG

Original Issue Date

05/14/1999

Effective Date

05/14/1999

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006