License holder summary

EDISON LAKES ORTHOPEDIC is a Medical Licensing Board - Medical Corporation licensed to practice in Indiana. The address on file for EDISON LAKES ORTHOPEDIC is SURGERY & SPORTS MEDICINE P C, 109 SOUTH ST LOUIS BOULEVARD, SOUTH BEND IN 46617. This licensed professional license is not current. The license was granted 08/14/1992 and expired on 01/31/1996.

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 2024-05-09 13:16:00 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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