MICHAEL LUCIANO TAKAGI

Idaho  PA-791   Canceled

This Idaho license was held by MICHAEL LUCIANO TAKAGI. The license is no longer active. It was granted on 02/12/2009 and expired on 08/01/2014

LICENSE DETAILS

  • License Number: PA-791
  • Category: Board Of Medicine
  • Status: Canceled
  • Date Granted: 02/12/2009 (about 16 years ago)
  • Expiry Date: 08/01/2014 (almost 11 years ago)

LOCATIONS

A Residential

P O BOX 562 CONDON OR 97823