Indiana
Professional Licensing Agency
Clay C. Prince
Medical Residency Permit
License number
11010762A
Date granted
06/22/2001
Date expires
06/30/2002
Class
Medical Residency Permit
Status
Superceded
Address
Fort Wayne IN 46804
indianalicensing.org
ID 5978729
LAST UPDATED 2024-04-06 12:31:01 UTC
LAST UPDATED 2024-04-06 12:31:01 UTC
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