Indiana
Professional Licensing Agency
Ear Nose & Throat Assoc., P. C.
Medical Licensing Board - Medical Corporation
License number
50000001A
Date granted
09/25/1963
Date expires
01/31/2016
Class
Medical Licensing Board - Medical Corporation
Status
Active
Address
10021 DUPONT CIRCLE COURT, FORT WAYNE IN 46825
indianalicensing.org
ID 24826549
LAST UPDATED 2026-06-03 18:42:07 UTC
LAST UPDATED 2026-06-03 18:42:07 UTC
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