Theodore Radja Manullang
Physician in Salt Lake City, UT

License number
Utah 309519-8905
Issued Date
Jun 26, 1996
Expiration Date
Apr 30, 2000
Category
Physician
Type
Physician/Surgeon CS (Schedule 2-5)
Address
Address
Salt Lake City, UT
LicenseFiles verified this license of Nov 20, 2016 at the Utah Division of Occupational and Professional Licensing.

Personal information

See more information about Theodore Radja Manullang at radaris.com
Name
Address
Phone
Theodore R Manullang
1632 Laird Ave, Salt Lake City, UT 84105
(801) 582-8956

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