| Street | Mae Sot District | ||
| City/Town | แม่สอด | ||
| State/Province/Region | จังหวัดตาก | ||
| Zip/Postal Code | 63110 | ||
| Phone Number | 055 532 590 | ||
| Country | Thailand |
| Full Name | Dr. Laisha Gislason DVM | ||
| Gender | female | ||
| Birthday | 1972-03-28 | ||
| Social Security Number |
| Credit card brand | Diners Club | ||
| Credit card number | 3021541793727746 | ||
| Expire | 2027/8 | ||
| CVV | 529 |