Indiana
Professional Licensing Agency
Aneta Costa
Controlled Substance Registration - Physician
License number
01070617B
Date granted
02/03/2012
Date expires
10/31/2013
Class
Controlled Substance Registration - Physician
Status
Expired
Address
Porter Healthcare, 814 LaPorte Avenue, Valparaiso IN 46383
indianalicensing.org
ID 5928025
LAST UPDATED 2024-03-04 18:04:57 UTC
LAST UPDATED 2024-03-04 18:04:57 UTC
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