Indiana
Professional Licensing Agency
Liza Escuadro
Controlled Substance Registration - Physician
License number
01070238B
Date granted
09/26/2011
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
113 East Fourth Street, Michigan City IN 46360
indianalicensing.org
ID 5893012
LAST UPDATED 2024-06-14 18:07:28 UTC
LAST UPDATED 2024-06-14 18:07:28 UTC
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