Indiana
Professional Licensing Agency
Mark Vincent Konicki
Temporary Medical Doctor Permit
License number
99054172A
Date granted
10/04/2012
Date expires
01/04/2013
Class
Temporary Medical Doctor Permit
Status
Superceded
Address
Fort Wayne IN 46804
indianalicensing.org
ID 27838580
LAST UPDATED 2024-05-13 03:40:57 UTC
LAST UPDATED 2024-05-13 03:40:57 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.