License holder summary

Larissa M Dimitrov is a Medical Residency Permit licensed to practice in Indiana. The address on file for Larissa M Dimitrov is westfield IN 46074-1106. This licensed professional license is not current. The license was granted 06/01/2004 and expired on 06/30/2007.

Indiana

Professional Licensing Agency

Larissa M Dimitrov
Medical Residency Permit
License number
11012117A
Date granted
06/01/2004
Date expires
06/30/2007
Class
Medical Residency Permit
Status
Superceded
Address
westfield IN 46074-1106
indianalicensing.org
ID 5998896
LAST UPDATED 2024-03-27 18:52:42 UTC

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