MARK SAMUEL TAKAGISHI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054587

License Status

NOT RENEWED

Business

First Name

MARK

Middle

SAMUEL

Last Name

TAKAGISHI

Suffix

Business Name

MARK SAMUEL TAKAGISHI MD

Original Issue Date

05/13/1977

Effective Date

05/13/1977

Expiration Date

07/31/1984

City

EAST LANSING

State

Zip

48823

County

MICHIGAN

Ever Disciplined

LastModifiedDate

09/20/2006