License holder summary

Deaconess Primary Care-Fort Branch is a Radiology - Radiation Facility Medical licensed to practice in Indiana. The address on file for Deaconess Primary Care-Fort Branch is 802 East Oak Street, Fort Branch IN 47648-0185. This licensed professional license is not current. The license was granted 06/25/2002 and expired on 11/07/2003.

Indiana

Professional Licensing Agency

Deaconess Primary Care-Fort Branch
Radiology - Radiation Facility Medical
License number
XF200999
Date granted
06/25/2002
Date expires
11/07/2003
Class
Radiology - Radiation Facility Medical
Status
Closed Facility
Address
802 East Oak Street, Fort Branch IN 47648-0185
indianalicensing.org
ID 24942004
LAST UPDATED 2024-02-28 06:04:46 UTC

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