YAI SUPAWIT BURANAKUL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

NOT RENEWED

Business

First Name

YAI

Middle

SUPAWIT

Last Name

BURANAKUL

Suffix

Business Name

YAI SUPAWIT BURANAKUL MD

Original Issue Date

09/22/2003

Effective Date

06/01/2011

Expiration Date

07/31/2014

City

DANVILLE

State

Zip

61832

County

VERMILION

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

04/05/2020