THANOM TEMIYASATHIT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054080

License Status

NOT RENEWED

Business

First Name

THANOM

Last Name

TEMIYASATHIT

Suffix

Business Name

THANOM TEMIYASATHIT MD

Original Issue Date

01/13/1977

Effective Date

04/18/2017

Expiration Date

09/30/2020

City

BLOOMINGTON

State

Zip

61707

County

MCLEAN

Ever Disciplined

LastModifiedDate

01/14/2021