License holder summary

THANOMSAKDI KULLAVANIJAYA is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for THANOMSAKDI KULLAVANIJAYA is ST ANTHONY MEDICAL CTR, MAIN & FRANCISCAN RD, CROWN POINT IN 46307. This licensed professional license is not current. The license was granted 04/18/1991 and expired on 06/30/1999.

Indiana

Professional Licensing Agency

THANOMSAKDI KULLAVANIJAYA
Controlled Substance Registration - Physician
License number
01039179B
Date granted
04/18/1991
Date expires
06/30/1999
Class
Controlled Substance Registration - Physician
Status
Expired
Address
ST ANTHONY MEDICAL CTR, MAIN & FRANCISCAN RD, CROWN POINT IN 46307
indianalicensing.org
ID 5841955
LAST UPDATED 2026-05-22 03:14:11 UTC

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