WORALAK KALYAWONGSA MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036049538

License Status

INACTIVE

Business

First Name

WORALAK

Last Name

KALYAWONGSA

Suffix

Business Name

WORALAK KALYAWONGSA MD

Original Issue Date

08/28/1974

Effective Date

08/28/1974

Expiration Date

07/31/1987

City

MISHAWAKA

State

Zip

46544

County

INDIANA

Ever Disciplined

LastModifiedDate

09/20/2006