KEN JULIAN TAKEKOSHI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114264

License Status

NOT RENEWED

Business

Title

First Name

KEN

Middle

JULIAN

Last Name

TAKEKOSHI

Business Name

KEN JULIAN TAKEKOSHI MD

Original Issue Date

07/27/2005

Effective Date

06/21/2017

Expiration Date

09/30/2020

City

MENDOTA HEIGHTS

State

Zip

55118

County

MINNESOTA

Ever Disciplined

LastModifiedDate

01/14/2021