Indiana
Professional Licensing Agency
Maurits Jan Wiersema
Medical Residency Permit
License number
11003748A
Date granted
05/26/1987
Date expires
06/30/1991
Class
Medical Residency Permit
Status
Expired
Address
Fort Wayne IN 46804
indianalicensing.org
ID 5979412
LAST UPDATED 2026-05-27 06:26:35 UTC
LAST UPDATED 2026-05-27 06:26:35 UTC
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