MARK SAMUEL TAKAGISHI MD - Medical Doctor License in Michigan | # 036054587

MARK SAMUEL TAKAGISHI MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054587

License Status

NOT RENEWED

Business

N

First Name

MARK

Middle

SAMUEL

Last Name

TAKAGISHI

Suffix

MD

Business Name

MARK SAMUEL TAKAGISHI MD

Original Issue Date

05/13/1977

Effective Date

05/13/1977

Expiration Date

07/31/1984

State

MI

Ever Disciplined

N

LastModifiedDate

09/20/2006