Indiana
Professional Licensing Agency
ORL P C
Medical Licensing Board - Medical Corporation
License number
50002630A
Date granted
01/03/1985
Date expires
01/31/1998
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
800 BROADWAY, FORT WAYNE IN 46802
indianalicensing.org
ID 24826844
LAST UPDATED 2026-03-18 19:15:14 UTC
LAST UPDATED 2026-03-18 19:15:14 UTC
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