License holder summary

Theodore C C Fong is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Theodore C C Fong is 316 BELLAIRE DRIVE, MADISON IN 47250. This licensed professional license is not current. The license was granted 10/31/1986 and expired on 06/30/1989.

Indiana

Professional Licensing Agency

Theodore C C Fong
Controlled Substance Registration - Physician
License number
01018529B
Date granted
10/31/1986
Date expires
06/30/1989
Class
Controlled Substance Registration - Physician
Status
Expired
Address
316 BELLAIRE DRIVE, MADISON IN 47250
indianalicensing.org
ID 5887447
LAST UPDATED 2024-02-17 18:44:39 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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