License holder summary

Mackenzie Elizabeth Lupov is a Medical Residency Permit licensed to practice in Indiana. The address on file for Mackenzie Elizabeth Lupov is Bloomington IN 47403. This licensed professional license is not current. The license was granted 06/05/2009 and expired on 06/30/2012.

Indiana

Professional Licensing Agency

Mackenzie Elizabeth Lupov
Medical Residency Permit
License number
11014966A
Date granted
06/05/2009
Date expires
06/30/2012
Class
Medical Residency Permit
Status
Superceded
Address
Bloomington IN 47403
indianalicensing.org
ID 5969270
LAST UPDATED 2024-05-15 14:07:08 UTC

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