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Superceded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 2026-05-18 08:08:17 UTC
LAST UPDATED 2026-05-18 08:08:17 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.