Wisconsin
Department of Safety and Professional Services
Head, Kitchener P
Medicine And Surgery
License number
29140-20
Date granted
03/24/1988
Date expires
11/01/1989
Class
Medicine And Surgery
Status
Expired
wisconsinmedicine.org
ID 35607759
LAST UPDATED 2026-05-02 04:25:52 UTC
LAST UPDATED 2026-05-02 04:25:52 UTC
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