Indiana
Professional Licensing Agency
SPORTS MEDICINE & JOINT
Medical Licensing Board - Medical Corporation
License number
50001635A
Date granted
11/16/1979
Date expires
01/31/2000
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
RECONSTRUCTIVE SURGERY PC, 1199 HADLEY ROAD, MOORESVILLE IN 46158
indianalicensing.org
ID 24831576
LAST UPDATED 2026-05-10 13:13:46 UTC
LAST UPDATED 2026-05-10 13:13:46 UTC
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