Wisconsin
Department of Safety and Professional Services
Noble, Lane A
Medicine And Surgery
License number
55143-21
Date granted
11/17/2010
Date expires
02/28/2014
Class
Medicine And Surgery
Status
Expired
wisconsinmedicine.org
ID 36367131
LAST UPDATED 2026-04-01 16:30:17 UTC
LAST UPDATED 2026-04-01 16:30:17 UTC
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