BERNADETA LEEGAN WIBISONO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036127633

License Status

ACTIVE

Business

Title

First Name

BERNADETA

Middle

LEEGAN

Last Name

WIBISONO

Business Name

BERNADETA LEEGAN WIBISONO MD

Original Issue Date

04/19/2011

Effective Date

05/27/2023

Expiration Date

07/31/2026

City

MARTINEZ

State

Zip

94553

County

WILL

Ever Disciplined

LastModifiedDate

05/27/2023