License holder summary

NORTHEAST INDIANA RADIOLOGY PC is a Medical Licensing Board - Medical Corporation licensed to practice in Indiana. The address on file for NORTHEAST INDIANA RADIOLOGY PC is 1408 OLD LANTERN TRAIL, FORT WAYNE IN 46825. This licensed professional license is not current. The license was granted 07/18/1991 and expired on 01/31/1994.

Indiana

Professional Licensing Agency

NORTHEAST INDIANA RADIOLOGY PC
Medical Licensing Board - Medical Corporation
License number
50003355A
Date granted
07/18/1991
Date expires
01/31/1994
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
1408 OLD LANTERN TRAIL, FORT WAYNE IN 46825
indianalicensing.org
ID 24826821
LAST UPDATED 2024-03-04 16:17:44 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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