Indiana
Professional Licensing Agency
West Main Street Medical
Medical Licensing Board - Medical Corporation
License number
50003911A
Date granted
12/13/1996
Date expires
01/31/2016
Class
Medical Licensing Board - Medical Corporation
Status
Active
Address
CENTER P C, 4760 WEST U S 40, RICHMOND IN 47374
indianalicensing.org
ID 24833408
LAST UPDATED 2026-04-04 19:20:55 UTC
LAST UPDATED 2026-04-04 19:20:55 UTC
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