Ohio
Board of Licensing
Soto, Wendy-Walden Ponds Primary Care
Medical Board - 41.Pa Supervision Agreement
License number
41.14252-SA
Date granted
02/28/2012
Date expires
01/31/2015
Class
Medical Board - 41.Pa Supervision Agreement
Status
Active (In Renewal)
Address
Dayton, OH 45417
ohiolicensing.org
ID 29494252
LAST UPDATED 2026-04-27 08:11:29 UTC
LAST UPDATED 2026-04-27 08:11:29 UTC