License holder summary

Beulah Theodore Penumudi is a Medical Residency Permit licensed to practice in Indiana. The address on file for Beulah Theodore Penumudi is Fort Wayne IN 46825. This licensed professional license is not current. The license was granted 06/04/2001 and expired on 06/30/2004.

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

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