SAMER THANAVARO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

NOT RENEWED

Business

First Name

SAMER

Last Name

THANAVARO

Business Name

SAMER THANAVARO

Original Issue Date

05/24/2000

Effective Date

05/24/2000

Expiration Date

07/31/2005

City

VANDALIA

State

Zip

62471

County

FAYETTE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020