License holder summary

NORTHEAST O B - G Y N P C is a Medical Licensing Board - Medical Corporation licensed to practice in Indiana. The address on file for NORTHEAST O B - G Y N P C is 2710 LAKE AVENUE, FORT WAYNE IN 46805. This licensed professional license is not current. The license was granted 09/22/1980 and expired on 01/31/2004.

Indiana

Professional Licensing Agency

NORTHEAST O B - G Y N P C
Medical Licensing Board - Medical Corporation
License number
50001834A
Date granted
09/22/1980
Date expires
01/31/2004
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
2710 LAKE AVENUE, FORT WAYNE IN 46805
indianalicensing.org
ID 24826824
LAST UPDATED 2024-03-08 20:38:50 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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