THANAD SRIUSSADA SHAY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036048357

License Status

ACTIVE

Business

First Name

THANAD SRIUSSADA

Last Name

SHAY

Suffix

Business Name

THANAD SRIUSSADA SHAY MD

Original Issue Date

09/19/1973

Effective Date

07/08/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61606

County

PEORIA

Ever Disciplined

LastModifiedDate

07/08/2023