License holder summary

John Edward Wagoner is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for John Edward Wagoner is 1627 Skyline Road, Lafayette IN 47905-5590. This licensed professional license is current. The license was granted 09/30/1986 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

John Edward Wagoner
Controlled Substance Registration - Physician
License number
01020202B
Date granted
09/30/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
1627 Skyline Road, Lafayette IN 47905-5590
indianalicensing.org
ID 5879867
LAST UPDATED 2024-03-02 03:31:55 UTC

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