Indiana
Professional Licensing Agency
Angela Phyllis LaSalle
Medical Residency Permit
License number
11007758A
Date granted
07/01/1996
Date expires
06/30/1998
Class
Medical Residency Permit
Status
Expired
Address
Fort Wayne IN 46845
indianalicensing.org
ID 5978582
LAST UPDATED 2024-02-20 01:08:13 UTC
LAST UPDATED 2024-02-20 01:08:13 UTC
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