License holder summary

FORT WAYNE PSYCHIATRY P C is a Medical Licensing Board - Medical Corporation licensed to practice in Indiana. The address on file for FORT WAYNE PSYCHIATRY P C is 2414 EAST STATE BLVD SUITE 301, FORT WAYNE IN 46808. This licensed professional license is current. The license was granted 12/17/1993 and expired on 01/31/2016.

Indiana

Professional Licensing Agency

FORT WAYNE PSYCHIATRY P C
Medical Licensing Board - Medical Corporation
License number
50003579A
Date granted
12/17/1993
Date expires
01/31/2016
Class
Medical Licensing Board - Medical Corporation
Status
Active
Address
2414 EAST STATE BLVD SUITE 301, FORT WAYNE IN 46808
indianalicensing.org
ID 24826621
LAST UPDATED 2024-05-07 18:09:16 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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