Indiana
Professional Licensing Agency
Moses Bassino-Umslo Tarawali
Medical Residency Permit
License number
11012904A
Date granted
06/21/2005
Date expires
06/30/2011
Class
Medical Residency Permit
Status
Expired
Address
Portage IN 46368
indianalicensing.org
ID 5994214
LAST UPDATED 2026-06-12 10:13:01 UTC
LAST UPDATED 2026-06-12 10:13:01 UTC
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