Indiana
Professional Licensing Agency
Peter P. Caccavallo
Controlled Substance Registration - Physician
License number
01053181B
Date granted
10/13/2000
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
13000 E. 136th Street, Suite 1100, Fishers IN 46037
indianalicensing.org
ID 11951245
LAST UPDATED 2024-05-13 16:34:19 UTC
LAST UPDATED 2024-05-13 16:34:19 UTC
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