License holder summary

Porter Portage Hospital-Lakeshore Urology is a Radiology - Radiation Facility Medical licensed to practice in Indiana. The address on file for Porter Portage Hospital-Lakeshore Urology is 3630 Willowcreek Road, Suite 4, Portage IN 46368-5075. This licensed professional license is not current. The license was granted 03/14/2006 and expired on 02/22/2010.

Indiana

Professional Licensing Agency

Porter Portage Hospital-Lakeshore Urology
Radiology - Radiation Facility Medical
License number
XF200877
Date granted
03/14/2006
Date expires
02/22/2010
Class
Radiology - Radiation Facility Medical
Status
Closed Facility
Address
3630 Willowcreek Road, Suite 4, Portage IN 46368-5075
indianalicensing.org
ID 24944102
LAST UPDATED 2026-08-11 09:40:25 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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