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Case Number and Status

Case Number: I-200-19102-761401

Submitted on:

CERTIFIED

on:

Employment

From: 2019-07-31

To: 2022-07-30 (1,095 days)

Address

7916 West Jefferson Blvd
Fort Wayne, IN 46804

Phone

2604346462


Attorney Summary

Location
Memphis, TN

Job Summary

Job Title
Family Physician
City and State
Fort Wayne, INDIANA
County
Allen

Soc Code
29-1062.00
Naics Code
Industry Code
621111