License holder summary

DERRICK D JETER M D P C is a Medical Licensing Board - Medical Corporation licensed to practice in Indiana. The address on file for DERRICK D JETER M D P C is 9108 COLUMBIA AVENUE, MUNSTER IN 46321. This licensed professional license is not current. The license was granted 08/05/1998 and expired on 01/31/2004.

Indiana

Professional Licensing Agency

DERRICK D JETER M D P C
Medical Licensing Board - Medical Corporation
License number
50004075A
Date granted
08/05/1998
Date expires
01/31/2004
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
9108 COLUMBIA AVENUE, MUNSTER IN 46321
indianalicensing.org
ID 24832011
LAST UPDATED 2024-04-04 10:40:32 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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