Department of State
Board of Medicine
IRA DE
Medical Physician And Surgeon
License number
MD040866L
Date granted
12/11/1987
Date expires
12/31/1992
Class
Medical Physician And Surgeon
Status
Inactive
Address
BLOOMFIELD NJ 07003
medicinepa.com
ID 37602845
LAST UPDATED 2024-04-21 15:18:18 UTC
LAST UPDATED 2024-04-21 15:18:18 UTC
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