THANAD SRIUSSADA SHAY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

ACTIVE

Business

First Name

THANAD SRIUSSADA

Last Name

SHAY

Suffix

Business Name

THANAD SRIUSSADA SHAY MD

Original Issue Date

01/01/1997

Effective Date

07/08/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61606

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/08/2023