PHAISAL MANOMAIVAT MD - Medical Doctor License in New Jersey | # 036047988

PHAISAL MANOMAIVAT MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036047988

License Status

NOT RENEWED

Business

N

First Name

PHAISAL

Last Name

MANOMAIVAT

Suffix

MD

Business Name

PHAISAL MANOMAIVAT MD

Original Issue Date

08/23/1973

Effective Date

08/23/1973

State

NJ

Ever Disciplined

N

LastModifiedDate

09/20/2006