Indiana
Professional Licensing Agency
ACUTE CARE & EMERGENCY
Medical Licensing Board - Medical Corporation
License number
50002779A
Date granted
12/27/1985
Date expires
01/31/1996
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
SPECIALIST P C, 3610 BROOKLYN AVENUE, FORT WAYNE IN 46809
indianalicensing.org
ID 24826455
LAST UPDATED 2024-03-22 16:55:20 UTC
LAST UPDATED 2024-03-22 16:55:20 UTC
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