License holder summary

LAKE AVENUE DIALYSIS is a Medical Licensing Board - Medical Corporation licensed to practice in Indiana. The address on file for LAKE AVENUE DIALYSIS is CENTER P C, 3525 LAKE AVENUE #4, FORT WAYNE IN 46805. This licensed professional license is not current. The license was granted 12/12/1986 and expired on 01/31/1996.

Indiana

Professional Licensing Agency

LAKE AVENUE DIALYSIS
Medical Licensing Board - Medical Corporation
License number
50002911A
Date granted
12/12/1986
Date expires
01/31/1996
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
CENTER P C, 3525 LAKE AVENUE #4, FORT WAYNE IN 46805
indianalicensing.org
ID 24826756
LAST UPDATED 2026-04-11 02:06:51 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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