License holder summary

PHUPHANICH, SURASAK, MD is a Medical - Physician licensed to practice in Georgia. The address on file for PHUPHANICH, SURASAK, MD is 1365 CLIFTON ROAD NE | WINSHIP CANCER INSTITUE, Atlanta 30322. This doctor license is not current. The license was granted 08/08/2003 and expired on 04/30/2009.

Georgia

Composite Medical Board

PHUPHANICH, SURASAK, MD
Medical - Physician
License number
053514
Date granted
08/08/2003
Date expires
04/30/2009
Class
Medical - Physician
Status
Lapsed
Address
1365 CLIFTON ROAD NE | WINSHIP CANCER INSTITUE
georgiadoctors.net
ID 38072865
LAST UPDATED 2021-06-05 08:01:16 UTC

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