Indiana
Professional Licensing Agency
Jessica Wynne Statz
Medical Residency Permit
License number
11012232A
Date granted
06/04/2004
Date expires
06/30/2005
Class
Medical Residency Permit
Status
Expired
Address
South Bend IN 46634
indianalicensing.org
ID 5996308
LAST UPDATED 2024-03-30 11:28:12 UTC
LAST UPDATED 2024-03-30 11:28:12 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.