Ohio
Board of Licensing
Lake, Kevin- Merion Village Family Practice
Medical Board - 41.Pa Supervision Agreement
License number
41.16666-SA
Date granted
05/20/2013
Date expires
01/31/2015
Class
Medical Board - 41.Pa Supervision Agreement
Status
Active (In Renewal)
Address
1430 S High St., Vivian Lauterbach, Columbus, OH 43207
ohiolicensing.org
ID 29546350
LAST UPDATED 2024-03-21 10:17:13 UTC
LAST UPDATED 2024-03-21 10:17:13 UTC