License Directory

Manita Kanathanavanich Md

Active

Illinois license 036171413

License

Licensed by
Illinois Department of Financial and Professional Regulation
License number
036171413
Status
Active
First issued
August 1, 2024
Expires
July 31, 2029
License holder
Manita Kanathanavanich
Entity type
Individual

Classifications

More from the license record

Current term began
05/12/2026

Contact

Fort Wayne, IN 46804