Indiana
Professional Licensing Agency
SUSAN WYNN PETERSON
Controlled Substance Registration - Physician
License number
01046231B
Date granted
10/16/1997
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
1201 ALTGELD STREET, South Bend IN 46614
indianalicensing.org
ID 5922368
LAST UPDATED 2024-04-19 09:30:27 UTC
LAST UPDATED 2024-04-19 09:30:27 UTC
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