XAMNAN TULYASATHIEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

XAMNAN

Last Name

TULYASATHIEN

Suffix

Business Name

XAMNAN TULYASATHIEN MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2008

City

DIXON

State

Zip

61021

County

LEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011