NIRANAT DEJTIRANUKUL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

NIRANAT

Last Name

DEJTIRANUKUL

Suffix

Business Name

NIRANAT DEJTIRANUKUL MD

Original Issue Date

01/01/1997

Effective Date

05/30/2017

Expiration Date

09/30/2020

City

OLNEY

State

Zip

62450

County

RICHLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021