DHANASARN MONGKOLSMAI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

ACTIVE

Business

First Name

DHANASARN

Last Name

MONGKOLSMAI

Suffix

Business Name

DHANASARN MONGKOLSMAI MD

Original Issue Date

01/01/1997

Effective Date

04/21/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/21/2023