Indiana
Professional Licensing Agency
Dean Lawrence Lenz
Temporary Medical Doctor Permit
License number
99033156A
Date granted
07/02/2008
Date expires
10/02/2008
Class
Temporary Medical Doctor Permit
Status
Superceded
Address
Bloomington IN 47403
indianalicensing.org
ID 6128035
LAST UPDATED 2024-02-07 22:34:16 UTC
LAST UPDATED 2024-02-07 22:34:16 UTC
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