Indiana
Professional Licensing Agency
BENJAMIN MATTHEW HICKS
Medical Residency Permit
License number
11008109A
Date granted
07/01/1996
Date expires
06/30/1997
Class
Medical Residency Permit
Status
Expired
Address
FORT WAYNE IN 46804-4133
indianalicensing.org
ID 5978619
LAST UPDATED 2024-04-16 11:02:41 UTC
LAST UPDATED 2024-04-16 11:02:41 UTC
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