Indiana
Professional Licensing Agency
Allen S. Martin
Controlled Substance Registration - Physician
License number
01020997B
Date granted
02/28/1986
Date expires
06/30/2011
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1005 LARIMER DRIVE, Goshen IN 46526-5515
indianalicensing.org
ID 5858233
LAST UPDATED 2024-02-01 10:16:57 UTC
LAST UPDATED 2024-02-01 10:16:57 UTC
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