License holder summary

IPFW Lafayette Street Clinic is a Radiology - Radiation Facility Dental licensed to practice in Indiana. The address on file for IPFW Lafayette Street Clinic is 2700 Lafayette Street, Suite 100, Fort Wayne IN 46806-1100. This licensed professional license is not current. The license was granted 10/05/2006 and expired on 08/16/2013.

Indiana

Professional Licensing Agency

IPFW Lafayette Street Clinic
Radiology - Radiation Facility Dental
License number
XF903097
Date granted
10/05/2006
Date expires
08/16/2013
Class
Radiology - Radiation Facility Dental
Status
Closed Facility
Address
2700 Lafayette Street, Suite 100, Fort Wayne IN 46806-1100
indianalicensing.org
ID 24932260
LAST UPDATED 2024-03-02 03:55:16 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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