Indiana
Professional Licensing Agency
Family & Children Behavioral Health, PC
Medical Licensing Board - Medical Corporation
License number
50004594A
Date granted
02/19/2004
Date expires
01/31/2016
Class
Medical Licensing Board - Medical Corporation
Status
Active
Address
909 E. State Blvd, Fort Wayne IN 46805
indianalicensing.org
ID 24826565
LAST UPDATED 2024-04-18 19:08:35 UTC
LAST UPDATED 2024-04-18 19:08:35 UTC
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