License holder summary

Summit Pediatric and Adolescent Center, PC is a Medical Licensing Board - Medical Corporation licensed to practice in Indiana. The address on file for Summit Pediatric and Adolescent Center, PC is 1011 Ivy Creek Cove, Fort Wayne IN 46804. This licensed professional license is not current. The license was granted 11/04/2005 and expired on 01/31/2008.

Indiana

Professional Licensing Agency

Summit Pediatric and Adolescent Center, PC
Medical Licensing Board - Medical Corporation
License number
50004762A
Date granted
11/04/2005
Date expires
01/31/2008
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
1011 Ivy Creek Cove, Fort Wayne IN 46804
indianalicensing.org
ID 24827027
LAST UPDATED 2026-06-21 23:29:44 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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