Indiana
Professional Licensing Agency
Anastacia Payot Lagunzad
Controlled Substance Registration-Osteopathic Physician
License number
02002549B
Date granted
12/09/2002
Date expires
10/31/2015
Class
Controlled Substance Registration-Osteopathic Physician
Status
Active
Address
Cannelton Clinic, LLC, 510 Washington Street, Cannelton IN 47520
indianalicensing.org
ID 5796292
LAST UPDATED 2024-05-15 15:23:20 UTC
LAST UPDATED 2024-05-15 15:23:20 UTC
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