License holder summary

Jefferson Pediatrics is a Medical Licensing Board - Medical Corporation licensed to practice in Indiana. The address on file for Jefferson Pediatrics is 3919 WEST JEFFERSON BLVD STE 1, FORT WAYNE IN 46804. This licensed professional license is current. The license was granted 09/28/1996 and expired on 01/31/2016.

Indiana

Professional Licensing Agency

Jefferson Pediatrics
Medical Licensing Board - Medical Corporation
License number
50003876A
Date granted
09/28/1996
Date expires
01/31/2016
Class
Medical Licensing Board - Medical Corporation
Status
Active
Address
3919 WEST JEFFERSON BLVD STE 1, FORT WAYNE IN 46804
indianalicensing.org
ID 24826731
LAST UPDATED 2024-04-20 19:16:25 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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