License holder summary

ROMAN YASUO TAKASAKI is a Board Of Medicine licensed to practice in Idaho. The address on file for ROMAN YASUO TAKASAKI is 777 N. Raymond St. Boise ID 83704. This licensed professional license is not current. The license was granted 08/19/1988 and expired on 07/02/1990.

Idaho

Division of Occupational and Professional Licenses

ROMAN YASUO TAKASAKI
Board Of Medicine
License number
M-5401
Date granted
08/19/1988
Date expires
07/02/1990
Class
Board Of Medicine
Status
Canceled
Address
777 N. Raymond St. Boise ID 83704
idaholicensing.com
ID 48335416
LAST UPDATED 2024-03-02 01:43:27 UTC

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