PHANOMKIATE CHARUWORN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036047811

License Status

INACTIVE

Business

First Name

PHANOMKIATE

Last Name

CHARUWORN

Suffix

Business Name

PHANOMKIATE CHARUWORN MD

Original Issue Date

08/23/1973

Effective Date

08/23/1973

Expiration Date

07/31/1987

City

WAXAHACHIE

State

Zip

75165

County

TEXAS

Ever Disciplined

LastModifiedDate

09/20/2006