License holder summary

DOMINGO CRUZ DIAZ JR is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for DOMINGO CRUZ DIAZ JR is NORTHEASTERN CENTER, 220 SOUTH MAIN STREET, KENDALLVILLE IN 46755. This licensed professional license is not current. The license was granted 05/28/1987 and expired on 06/30/2003.

Indiana

Professional Licensing Agency

DOMINGO CRUZ DIAZ JR
Controlled Substance Registration - Physician
License number
01035934B
Date granted
05/28/1987
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
NORTHEASTERN CENTER, 220 SOUTH MAIN STREET, KENDALLVILLE IN 46755
indianalicensing.org
ID 5874910
LAST UPDATED 2024-03-16 22:09:07 UTC

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