Indiana
Professional Licensing Agency
EDISON LAKES ORTHOPEDIC
Medical Licensing Board - Medical Corporation
License number
50003466A
Date granted
08/14/1992
Date expires
01/31/1996
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
SURGERY & SPORTS MEDICINE P C, 109 SOUTH ST LOUIS BOULEVARD, SOUTH BEND IN 46617
indianalicensing.org
ID 24833967
LAST UPDATED 2026-04-05 16:10:10 UTC
LAST UPDATED 2026-04-05 16:10:10 UTC
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