Department of State
Board of Medicine
ILLSUK OH
Medical Physician And Surgeon
License number
MD036423L
Date granted
02/19/1976
Date expires
12/31/1978
Class
Medical Physician And Surgeon
Status
Expired
Address
BRIDGEPORT CT 06610
medicinepa.com
ID 37654349
LAST UPDATED 2026-05-22 04:57:48 UTC
LAST UPDATED 2026-05-22 04:57:48 UTC
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