Indiana
Professional Licensing Agency
SOUTHLAKE SURG
Medical Licensing Board - Medical Corporation
License number
50000036A
Date granted
10/24/1968
Date expires
01/31/1992
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
CLINIC INC, 151 SHORE DRIVE R R 642, PORTAGE IN 46368
indianalicensing.org
ID 24833097
LAST UPDATED 2024-02-08 08:03:12 UTC
LAST UPDATED 2024-02-08 08:03:12 UTC
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