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Physician Records |
Physician Last Name: | Wagle | |
Physician First Name: | Dattatraya | |
Physician Middle Name: | G | |
Address: | Address redacted | |
License Number: | 100780 | |
License Type: | MD | |
Year of Birth: | 1936 | |
Effective Date: | 06/22/2015 | |
Action Description for DOH Webpage: | Permanent license surrender issued pursuant to New York State Public Health Law Section 230.13. | |
Misconduct Description for DOH Webpage: | This action is not disciplinary in nature. | |
License Limitations or Conditions for DOH Webpage: | ||
Board Order: |
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