RUSTAN J WIERSMA MD - Medical Doctor License in Wisconsin | # 036054021

RUSTAN J WIERSMA MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054021

License Status

INACTIVE

Business

N

First Name

RUSTAN J

Last Name

WIERSMA

Suffix

MD

Business Name

RUSTAN J WIERSMA MD

Original Issue Date

12/14/1976

Effective Date

12/14/1976

Expiration Date

07/31/2005

State

WI

Ever Disciplined

N

LastModifiedDate

10/09/2006