Indiana
Professional Licensing Agency
Beulah Theodore Penumudi
Medical Residency Permit
License number
11010552A
Date granted
06/04/2001
Date expires
06/30/2004
Class
Medical Residency Permit
Status
Expired
Address
Fort Wayne IN 46825
indianalicensing.org
ID 5978628
LAST UPDATED 2024-02-22 01:33:34 UTC
LAST UPDATED 2024-02-22 01:33:34 UTC
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