License holder summary

NORTHEAST UROLOGY PC is a Medical Licensing Board - Medical Corporation licensed to practice in Indiana. The address on file for NORTHEAST UROLOGY PC is 527 WEST BERRY STREET, FORT WAYNE IN 46802. This licensed professional license is not current. The license was granted 07/24/1969 and expired on 01/31/1990.

Indiana

Professional Licensing Agency

NORTHEAST UROLOGY PC
Medical Licensing Board - Medical Corporation
License number
50000112A
Date granted
07/24/1969
Date expires
01/31/1990
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
527 WEST BERRY STREET, FORT WAYNE IN 46802
indianalicensing.org
ID 24826832
LAST UPDATED 2026-06-06 10:06:12 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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