Wisconsin
Department of Safety and Professional Services
OTS, MAX E
Medicine And Surgery
License number
29379-20
Date granted
06/23/1988
Date expires
10/31/2015
Class
Medicine And Surgery
Status
Active
wisconsinmedicine.org
ID 12776272
LAST UPDATED 2024-03-23 19:44:02 UTC
LAST UPDATED 2024-03-23 19:44:02 UTC
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