GUNNIGA SAMUDTAKUPT Physical Therapist License verification

Business Entity

NOT RENEWED

License Type

Physical Therapist

Description

LICENSED PHYSICAL THERAPIST

License Number

070006384

License Status

NOT RENEWED

Business

First Name

GUNNIGA

Last Name

SAMUDTAKUPT

Business Name

GUNNIGA SAMUDTAKUPT

Original Issue Date

02/20/1991

Effective Date

09/02/2020

Expiration Date

09/30/2022

City

CHICAGO

State

Zip

60618

County

COOK

Ever Disciplined

LastModifiedDate

11/28/2022