License holder summary

Thomas Modad Soeprono is a Health Care - Physician And Surgeon Residency License licensed to practice in Washington. This medical licensee license is not current. The license was granted 11/23/2010 and expired on 05/28/2014.

Washington

Medical Commission

Thomas Modad Soeprono
Health Care - Physician And Surgeon Residency License
License number
ML60163895
Date granted
11/23/2010
Date expires
05/28/2014
Class
Health Care - Physician And Surgeon Residency License
Status
Closed
wamedicine.com
ID 40008539
LAST UPDATED 2021-08-04 16:12:30 UTC

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