Wisconsin
Department of Safety and Professional Services
Dean, Russell Allyn
Medicine And Surgery
License number
25752-20
Date granted
12/08/1983
Date expires
10/31/2013
Class
Medicine And Surgery
Status
Expired
wisconsinmedicine.org
ID 12772740
LAST UPDATED 2026-03-17 07:10:48 UTC
LAST UPDATED 2026-03-17 07:10:48 UTC
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