Indiana
Professional Licensing Agency
SOUTHSIDE ORTHOPAEDIC
Medical Licensing Board - Medical Corporation
License number
50002105A
Date granted
07/30/1981
Date expires
01/31/2004
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
112 NORTH 17TH AVENUE # 100, BEECH GROVE IN 46107
indianalicensing.org
ID 24823855
LAST UPDATED 2026-05-21 16:36:30 UTC
LAST UPDATED 2026-05-21 16:36:30 UTC
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