TAKANORI FUKUSHIMA - Medical Doctor License in Pennsylvania | # 106000012

TAKANORI FUKUSHIMA

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000012

License Status

EXPIRED

Business

N

First Name

TAKANORI

Last Name

FUKUSHIMA

Business Name

TAKANORI FUKUSHIMA

Original Issue Date

01/27/1995

Effective Date

01/27/1995

Expiration Date

01/01/1997

State

PA

Ever Disciplined

N

LastModifiedDate

09/23/2006