KONGIET THAERA Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036059265

License Status

INACTIVE

Business

First Name

KONGIET

Last Name

THAERA

Business Name

KONGIET THAERA

Original Issue Date

08/27/1979

Effective Date

08/27/1979

Expiration Date

07/31/1993

City

DYER

State

Zip

46311

County

INDIANA

Ever Disciplined

LastModifiedDate

09/20/2006