Suthanya Srisuro, D.D.S., M.S.
Orthodontics · Godfrey, IL
UnclaimedD.D.S., M.S.NPI 1982829289
- Primary taxonomy
- 1223X0400X
- Enumerated
- 2007-04-13
- Practice location
- Godfrey, IL
- Last NPPES update
- 2007-07-09
State licenses
- IL · Dentist · NPPES self-reportedListed on NPI record
- IL · Dentist · LICENSED SPECIALIST IN DENTISTRYExpiredthrough 2012
- IL · Dentist · LICENSED DENTISTInactivethrough 2018
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.