License holder summary

Shelby Ann Dietrich Kenner is a Medical Residency Permit licensed to practice in Indiana. The address on file for Shelby Ann Dietrich Kenner is Fort Wayne IN 46806. This licensed professional license is not current. The license was granted 06/02/2004 and expired on 06/30/2006.

Indiana

Professional Licensing Agency

Shelby Ann Dietrich Kenner
Medical Residency Permit
License number
11012153A
Date granted
06/02/2004
Date expires
06/30/2006
Class
Medical Residency Permit
Status
Superceded
Address
Fort Wayne IN 46806
indianalicensing.org
ID 5979733
LAST UPDATED 2024-03-11 13:26:03 UTC

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