Indiana
Professional Licensing Agency
Southlake Pediatrics, P.C.
Medical Licensing Board - Medical Corporation
License number
50004816A
Date granted
01/24/2006
Date expires
01/31/2016
Class
Medical Licensing Board - Medical Corporation
Status
Active
Address
2504 Old Oak Drive, Valparaiso IN 46385
indianalicensing.org
ID 24835021
LAST UPDATED 2024-04-15 12:12:50 UTC
LAST UPDATED 2024-04-15 12:12:50 UTC
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