Person Information

Name:BARBARA TAKACH BODURA

Address Information

Address(city state zipcode):MUNHALL PA15120

License Information

Type:Prescriptive AuthoritySecondary Type:Number:006276
Profession:NursingStatus:Agreement Terminated
Issue Date:4/3/2007Expires:4/30/2009Last Renewed:

Prerequisite Information

Licensee:BODURA, BARBARA TAKACHRelationship:Prescriptive Authority
Type:Certified Registered Nurse PractitionerNumber:UP005764LStatus:Active
Date of Association:Date of Expiration:

Licensee:SALLOUM, IHSAN MRelationship:Collaborating Physician
Type:Medical Physician and SurgeonNumber:MD041652EStatus:Inactive
Date of Association:4/3/2007Date of Expiration:5/31/2007

License CSR Information

Drug Schedule 2:YDrug Schedule 3:YDrug Schedule 4:YDrug Schedule 5:

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