Indiana
Professional Licensing Agency
Dean Lloyd Mattox, II
Controlled Substance Registration - Physician
License number
01052822B
Date granted
08/15/2000
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
3250 Intertech Drive, Suite A, Angola IN 46703
indianalicensing.org
ID 5818561
LAST UPDATED 2024-05-23 16:54:46 UTC
LAST UPDATED 2024-05-23 16:54:46 UTC
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