MEDHA SUWANAWONGSE MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

INACTIVE

Business

First Name

MEDHA

Last Name

SUWANAWONGSE

Suffix

Business Name

MEDHA SUWANAWONGSE MD

Original Issue Date

01/05/1994

Effective Date

06/12/2008

Expiration Date

07/31/2011

City

HERRIN

State

Zip

62948

County

WILLIAMSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011