ROMSAI TONY BOONYASAI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

CANCELLED

Business

First Name

ROMSAI

Middle

TONY

Last Name

BOONYASAI

Suffix

Business Name

ROMSAI TONY BOONYASAI MD

Original Issue Date

11/20/2003

Effective Date

11/20/2003

Expiration Date

07/31/2005

City

FAIRVIEW HEIGHTS

State

Zip

62208

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006