License Directory

Suphavit Muttamara Md

Expired

Illinois 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

More from the license record

Current term began
08/28/1974

Contact

Mount Arlington, NJ 07856
New Jersey County