Delaware
Division of Professional Regulation
Manivanh Keobounnam
Controlled Substances - Physician Csr
License number
DR-0007014
Date granted
07/09/2009
Date expires
06/30/2015
Class
Controlled Substances - Physician Csr
Status
Active
Address
Wynnewood PA 19096
delawarelicensing.com
ID 20539821
LAST UPDATED 2026-05-02 05:14:17 UTC
LAST UPDATED 2026-05-02 05:14:17 UTC
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