Wisconsin
Department of Safety and Professional Services
Attn: Iwata, Jan L
Medicine And Surgery
License number
16673-875
Date granted
01/07/2000
Date expires
01/06/2001
Class
Medicine And Surgery
Status
Expired
wisconsinmedicine.org
ID 13738661
LAST UPDATED 2026-04-25 11:09:13 UTC
LAST UPDATED 2026-04-25 11:09:13 UTC
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