Ohio
Board of Licensing
Mills, Shelly-Defiance Family Practice
Medical Board - 41.Pa Supervision Agreement
License number
41.15041-SA
Date granted
08/09/2012
Date expires
01/31/2015
Class
Medical Board - 41.Pa Supervision Agreement
Status
Active (In Renewal)
Address
Lisa Hacker, 1250 Ralston Ave, Defiance, OH 43512
ohiolicensing.org
ID 29517792
LAST UPDATED 2024-02-18 02:05:52 UTC
LAST UPDATED 2024-02-18 02:05:52 UTC