MICHAEL NITHIPHAISAL YU DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

ACTIVE

Business

Title

First Name

MICHAEL

Middle

NITHIPHAISAL

Last Name

Business Name

MICHAEL NITHIPHAISAL YU DO

Original Issue Date

01/10/2025

Effective Date

01/10/2025

Expiration Date

07/31/2026

City

DIXON

State

Zip

61021

County

LEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/10/2025