License holder summary

ALFONSO LOPEZ is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for ALFONSO LOPEZ is P O BOX 1092, 446 WEST ARCH STREET, PORTLAND IN 47371. This licensed professional license is not current. The license was granted 05/31/1986 and expired on 06/30/2003.

Indiana

Professional Licensing Agency

ALFONSO LOPEZ
Controlled Substance Registration - Physician
License number
01020564B
Date granted
05/31/1986
Date expires
06/30/2003
Class
Controlled Substance Registration - Physician
Status
Expired
Address
P O BOX 1092, 446 WEST ARCH STREET, PORTLAND IN 47371
indianalicensing.org
ID 5911346
LAST UPDATED 2024-04-21 12:17:03 UTC

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