Wisconsin
Department of Safety and Professional Services
Congress, Mark I
Medicine And Surgery
License number
14998-20
Date granted
07/15/1964
Date expires
12/31/1983
Class
Medicine And Surgery
Status
Expired
wisconsinmedicine.org
ID 35594314
LAST UPDATED 2026-03-22 01:24:22 UTC
LAST UPDATED 2026-03-22 01:24:22 UTC
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