Indiana
Professional Licensing Agency
Fort Wayne Retina PC
Medical Licensing Board - Medical Corporation
License number
50004360A
Date granted
12/04/2001
Date expires
01/31/2016
Class
Medical Licensing Board - Medical Corporation
Status
Active
Address
7305 West Jefferson Boulevard, Fort Wayne IN 46804
indianalicensing.org
ID 24826614
LAST UPDATED 2024-04-29 00:12:16 UTC
LAST UPDATED 2024-04-29 00:12:16 UTC
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