SRIPEN LAVAVEJ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

NOT RENEWED

Business

First Name

SRIPEN

Last Name

LAVAVEJ

Suffix

Business Name

SRIPEN LAVAVEJ MD

Original Issue Date

01/01/1997

Effective Date

05/23/2014

Expiration Date

07/31/2017

City

PRINCETON

State

Zip

61356

County

BUREAU

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017