License holder summary

CONNELLY FAMILY PRACTICE is a Medical Licensing Board - Medical Corporation licensed to practice in Indiana. The address on file for CONNELLY FAMILY PRACTICE is 4306 LAKE AVE, FORT WAYNE IN 46815. This licensed professional license is not current. The license was granted 01/22/1970 and expired on 12/31/1981.

Indiana

Professional Licensing Agency

CONNELLY FAMILY PRACTICE
Medical Licensing Board - Medical Corporation
License number
50000164A
Date granted
01/22/1970
Date expires
12/31/1981
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
4306 LAKE AVE, FORT WAYNE IN 46815
indianalicensing.org
ID 24826524
LAST UPDATED 2026-03-23 19:49:31 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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