License holder summary

Alfred Francis Fasola is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Alfred Francis Fasola is 460 NORTH BRAESIDE DRIVE, INDIANAPOLIS IN 46260. This licensed professional license is not current. The license was granted 10/31/1984 and expired on 06/30/2009.

Indiana

Professional Licensing Agency

Alfred Francis Fasola
Controlled Substance Registration - Physician
License number
01018545B
Date granted
10/31/1984
Date expires
06/30/2009
Class
Controlled Substance Registration - Physician
Status
Expired
Address
460 NORTH BRAESIDE DRIVE, INDIANAPOLIS IN 46260
indianalicensing.org
ID 5868853
LAST UPDATED 2024-04-19 09:23:02 UTC

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