SUPOTE PHIPATANAKUL MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036044428

License Status

INACTIVE

Business

First Name

SUPOTE

Last Name

PHIPATANAKUL

Suffix

Business Name

SUPOTE PHIPATANAKUL MD

Original Issue Date

07/09/1971

Effective Date

07/09/1971

Expiration Date

07/31/1990

City

KIRKWOOD

State

Zip

63122

County

MISSOURI

Ever Disciplined

LastModifiedDate

09/20/2006