LEO THAI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062393

License Status

CANCELLED

Business

Title

First Name

LEO

Last Name

THAI

Business Name

LEO THAI MD

Original Issue Date

07/05/2015

Effective Date

07/05/2015

Expiration Date

07/04/2018

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

06/24/2015