Ohio
Board of Licensing
Santoso, Ivan - Alliance Medical Associates
Medical Board - 41.Pa Supervision Agreement
License number
41.3540-SA
Date granted
08/19/2003
Date expires
01/31/2005
Class
Medical Board - 41.Pa Supervision Agreement
Status
Inactive
Address
264 E. Rice St.,, Alliance, OH 44601
ohiolicensing.org
ID 28677401
LAST UPDATED 2026-05-19 00:57:24 UTC
LAST UPDATED 2026-05-19 00:57:24 UTC