| | Physician Last Name: | Kangsumrith |
| | Physician First Name: | Suriyun |
| | Physician Middle Name: | |
| | Address: | 943 South Power Road
Mesa, Arizona 85206 |
| | License Number: | 115178 |
| | License Type: | MD |
| | Year of Birth: |
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| | Effective Date: | 01/15/1997 |
| | Action Description for DOH Webpage: | License revocation |
| | Misconduct Description for DOH Webpage: | The Hearing Committee sustained the charge finding the physician had been disciplined by the Arizona State Board of Medical Examiners for making false statements on his medical license renewal application. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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