License holder summary

Susan A Birndorf is a Controlled Substance Registration-Osteopathic Physician licensed to practice in Indiana. The address on file for Susan A Birndorf is MEDICAL GROUP OF FORT WAYNE, 7836 WEST JEFFERSON BOULEVARD, Fort Wayne IN 46801-2505. This licensed professional license is not current. The license was granted 07/18/2000 and expired on 06/30/2003.

Indiana

Professional Licensing Agency

Susan A Birndorf
Controlled Substance Registration-Osteopathic Physician
License number
02002207B
Date granted
07/18/2000
Date expires
06/30/2003
Class
Controlled Substance Registration-Osteopathic Physician
Status
Expired
Address
MEDICAL GROUP OF FORT WAYNE, 7836 WEST JEFFERSON BOULEVARD, Fort Wayne IN 46801-2505
indianalicensing.org
ID 5800851
LAST UPDATED 2024-02-26 13:08:48 UTC

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