License holder summary

Lake, Susan-Gahanna Family Practice is a Medical Board - 41.Pa Supervision Agreement licensed to practice in Ohio. The address on file for Lake, Susan-Gahanna Family Practice is 4550 N. Hamilton Rd, Gahanna, OH 43230. This licensed professional license is not current. The license was granted 04/25/2011 and expired on 01/31/2015.

Ohio

Board of Licensing

Lake, Susan-Gahanna Family Practice
Medical Board - 41.Pa Supervision Agreement
License number
41.12934-SA
Date granted
04/25/2011
Date expires
01/31/2015
Class
Medical Board - 41.Pa Supervision Agreement
Status
Inactive
Address
4550 N. Hamilton Rd, Gahanna, OH 43230
ohiolicensing.org
ID 29417042
LAST UPDATED 2024-03-02 18:18:20 UTC

This website is unaffiliated with Ohio and its licensing agencies. Please verify all information directly with the relevant official government authority.

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