LARYSA TARASHEVSKA WICKMAN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036117341

License Status

NOT RENEWED

Business

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

City

YPSILANTI

State

Zip

48197

County

WAYNE

Ever Disciplined

LastModifiedDate

11/06/2008