YUDI WIBISONO DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036173815

License Status

ACTIVE

Business

Title

First Name

YUDI

Last Name

WIBISONO

Business Name

YUDI WIBISONO DO

Original Issue Date

02/23/2025

Effective Date

02/23/2025

Expiration Date

07/31/2026

City

SALT LAKE CITY

State

Zip

84116

Ever Disciplined

LastModifiedDate

02/23/2025