Indiana
Professional Licensing Agency
Alison Patt Mathew
Controlled Substance Registration - Physician
License number
01057035B
Date granted
01/09/2003
Date expires
06/30/2009
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Prime Care Physician Network, 2014 South Main Street Ste A, Goshen IN 46526
indianalicensing.org
ID 5858227
LAST UPDATED 2024-02-24 14:26:08 UTC
LAST UPDATED 2024-02-24 14:26:08 UTC
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