SOMPONG DAENGSURISRI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

CANCELLED

Business

First Name

SOMPONG

Last Name

DAENGSURISRI

Suffix

Business Name

SOMPONG DAENGSURISRI MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2008

City

GODFREY

State

Zip

62035

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008