License holder summary

GREGG ROBERT MATTISON is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for GREGG ROBERT MATTISON is Fort Wayne Radiology Association LLC, 3707 New Vision Dr. P.O. Box 5602, Fort Wayne IN 46895-5602. This licensed professional license is current. The license was granted 07/16/1986 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

GREGG ROBERT MATTISON
Controlled Substance Registration - Physician
License number
01035188B
Date granted
07/16/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Fort Wayne Radiology Association LLC, 3707 New Vision Dr. P.O. Box 5602, Fort Wayne IN 46895-5602
indianalicensing.org
ID 5853381
LAST UPDATED 2024-02-18 18:31:44 UTC

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