LARYSA TARASHEVSKA WICKMAN - Medical Doctor License in Michigan | # 036117341

LARYSA TARASHEVSKA WICKMAN

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036117341

License Status

NOT RENEWED

Business

N

First Name

LARYSA

Middle

TARASHEVSKA

Last Name

WICKMAN

Business Name

LARYSA TARASHEVSKA WICKMAN

Original Issue Date

12/18/2006

Effective Date

12/18/2006

Expiration Date

07/31/2008

State

MI

Ever Disciplined

N

LastModifiedDate

11/06/2008