SAMPANTA BOONJARERN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036047641

License Status

INACTIVE

Business

First Name

SAMPANTA

Last Name

BOONJARERN

Suffix

Business Name

SAMPANTA BOONJARERN MD

Original Issue Date

08/17/1973

Effective Date

08/17/1973

Expiration Date

07/31/1987

City

LOWELL

State

Zip

46357

County

INDIANA

Ever Disciplined

LastModifiedDate

09/20/2006