Suphavit Muttamara Md
ExpiredIllinois license 036049598
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 036049598
- Status
- Expired (Not Renewed)
- First issued
- August 28, 1974
- Expired
- July 31, 1984
- License holder
- Suphavit Muttamara Md
- Entity type
- Individual
Classifications
- Licensed Physician and Surgeon (Medical Board) Physicians & Surgeons
More from the license record
- Current term began
- 08/28/1974
Contact
Mount Arlington, NJ 07856
New Jersey County