License holder summary

THEODORE RADJA MANULLANG is a Physician - Physician & Surgeon licensed to practice in Utah. The address on file for THEODORE RADJA MANULLANG is SALT LAKE CITY, UT 841051732. This licensed professional license is not current. The license was granted 09/11/1995 and expired on 04/30/2000.

Utah

Division of Occupational and Professional Licensing

THEODORE RADJA MANULLANG
Physician - Physician & Surgeon
License number
309519-1205
Date granted
09/11/1995
Date expires
04/30/2000
Class
Physician - Physician & Surgeon
Status
Expired
Address
SALT LAKE CITY, UT 841051732
utahlicensing.org
ID 29935773
LAST UPDATED 2026-05-05 01:42:50 UTC

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