Indiana
Professional Licensing Agency
Son Huu Phung
Controlled Substance Registration - Physician
License number
01071370B
Date granted
06/29/2012
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
Elkhart Clinic, 303 South Nappanee Street, Elkhart IN 46514
indianalicensing.org
ID 5848470
LAST UPDATED 2024-03-31 10:49:10 UTC
LAST UPDATED 2024-03-31 10:49:10 UTC
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