Pennsylvania
Department of State
PRAKORB ISARIYAWONGSE
Medicine - Written Agreement
License number
MX002531
Date granted
05/14/2004
Class
Medicine - Written Agreement
Status
Inactive
Address
MEDICAL DEPARTMENT 50 OVERLOOK DRIVE La Belle PA 15450
palicensing.org
ID 16663929
LAST UPDATED 2026-06-02 14:42:43 UTC
LAST UPDATED 2026-06-02 14:42:43 UTC
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