Credential Summary - Renewal Requirements

Credential Summary for 21454-20
Name: Broekhuizen, Fredrik F
Credential Type: MEDICINE AND SURGERY (20)
Credential Number: 21454-20
Location: WHITEFISH BAY, WI
License Type: regular
Status License is not current (Expired)
Eligible To Practice: Not Eligible to Practice
First Fee Received: NO

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Renewal requirements for the year:
Requirement Code Complied? Complied Date


Requirement Code Description

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