SAMER THANAVARO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

ACTIVE

Business

First Name

SAMER

Last Name

THANAVARO

Business Name

SAMER THANAVARO

Original Issue Date

06/29/2001

Effective Date

06/08/2023

Expiration Date

07/31/2026

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/08/2023