Indiana
Professional Licensing Agency
Pediatric, Pulmonary & Critical Care, PC
Medical Licensing Board - Medical Corporation
License number
50004592A
Date granted
02/19/2004
Date expires
01/31/2016
Class
Medical Licensing Board - Medical Corporation
Status
Active
Address
7910 W. Jefferson Blvd, Ste 205, Fort Wayne IN 46804-4159
indianalicensing.org
ID 24826909
LAST UPDATED 2024-03-04 06:21:31 UTC
LAST UPDATED 2024-03-04 06:21:31 UTC
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