Surasak Phuphanich Md

License

Licensed by

Illinois Department of Financial and Professional Regulation

License number

036058266

Status

Expired (Not Renewed)

First issued

December 19, 1978

Expired

July 31, 1984

License holder

Surasak Phuphanich Md

Entity type

Individual

Classifications

• Licensed Physician and Surgeon (Medical Board) Physicians & Surgeons

More from the license record

Current term began

12/19/1978

Other Illinois licenses under this name

• IL
  Surasak Phuphanich Md

  License 33*****93

  Licensed Physician Controlled Substance (Medical Board)
  Expired

  Chicago, IL

  Expired Sep 1, 1982

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