License holder summary

Fort Wayne Interventional Pain Management is a Radiology - Radiation Facility Medical licensed to practice in Indiana. The address on file for Fort Wayne Interventional Pain Management is 2510 E. Dupont Road, Suite 115, Fort Wayne IN 46825. This licensed professional license is current. The license was granted 01/07/2014 and expired on 01/07/2015.

Indiana

Professional Licensing Agency

Fort Wayne Interventional Pain Management
Radiology - Radiation Facility Medical
License number
XF201676
Date granted
01/07/2014
Date expires
01/07/2015
Class
Radiology - Radiation Facility Medical
Status
Active
Address
2510 E. Dupont Road, Suite 115, Fort Wayne IN 46825
indianalicensing.org
ID 24942050
LAST UPDATED 2024-03-06 19:47:54 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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