THAVISAK PHURIPHAN MD - Medical Doctor License in New York | # 036054632

THAVISAK PHURIPHAN MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054632

License Status

NOT RENEWED

Business

N

First Name

THAVISAK

Last Name

PHURIPHAN

Suffix

MD

Business Name

THAVISAK PHURIPHAN MD

Original Issue Date

05/13/1977

Effective Date

05/13/1977

State

NY

Ever Disciplined

N

LastModifiedDate

09/20/2006