Indiana
Professional Licensing Agency
Jeuti B. Wylde, M.D., PSC
Medical Licensing Board - Medical Corporation
License number
50004387A
Date granted
01/18/2002
Date expires
01/31/2016
Class
Medical Licensing Board - Medical Corporation
Status
Active
Address
PO BOX 159 905 BEAVER RIDGE ROAD, Otisco IN 47163
indianalicensing.org
ID 24832867
LAST UPDATED 2024-05-01 00:53:40 UTC
LAST UPDATED 2024-05-01 00:53:40 UTC
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