TANUSIN PLOYSANGAM Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036089780

License Status

INACTIVE

Business

First Name

TANUSIN

Last Name

PLOYSANGAM

Business Name

TANUSIN PLOYSANGAM

Original Issue Date

10/07/1994

Effective Date

10/07/1994

Expiration Date

07/31/1996

City

MASON CITY

State

Zip

50401

Ever Disciplined

LastModifiedDate

02/15/2007