Indiana
Professional Licensing Agency
TIN HLA M D P C
Medical Licensing Board - Medical Corporation
License number
50003206A
Date granted
09/14/1989
Date expires
01/31/1998
Class
Medical Licensing Board - Medical Corporation
Status
Expired
Address
301 BOYD CIRCLE, MICHIGAN CITY IN 46360
indianalicensing.org
ID 24831297
LAST UPDATED 2024-04-05 21:06:16 UTC
LAST UPDATED 2024-04-05 21:06:16 UTC
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