| Physician Last Name: | Dagostino |
| Physician First Name: | James |
| Physician Middle Name: | |
| Address: | Prey Sar Prison
Kom Reang Village
Sangkat Prey Veng Khan Dang Kor
Phnom Penh, Cambodia |
| License Number: | 189886 |
| License Type: | MD |
| Year of Birth: |
1954
|
| Effective Date: | 11/16/2012 |
| Action Description for DOH Webpage: | License suspension until the physician complies with this order. |
| Misconduct Description for DOH Webpage: | The Hearing Committee sustained the charge finding the physician guilty of having been convicted in the Kingdom of Cambodia, Phnom Penh Preliminary Court of child prostitution and exploitation. |
| License Limitations or Conditions for DOH Webpage: | |
| Board Order: |
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