DEJA SUTHIKANT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

DEJA

Last Name

SUTHIKANT

Suffix

Business Name

DEJA SUTHIKANT MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1993

City

CHARLESTON

State

Zip

61920

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011

Case Number

1987002110

Action

Revocation

Discipline Start Date

10/21/1988

Discipline End Date

03/19/1992