License Directory

Supote Phipatanakul Md

Inactive

Illinois license 036044428

License

Licensed by
Illinois Department of Financial and Professional Regulation
License number
036044428
Status
Inactive
First issued
July 9, 1971
Expired
July 31, 1990
License holder
Supote Phipatanakul Md
Entity type
Individual

Classifications

More from the license record

Current term began
07/09/1971

Contact

Kirkwood, MO 63122
Missouri County