License holder summary

ANTWAN MARDINI is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for ANTWAN MARDINI is 1530 North 7th Street Suite 111, Terre Haute IN 47807. This licensed professional license is current. The license was granted 04/30/1998 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

ANTWAN MARDINI
Controlled Substance Registration - Physician
License number
01048595B
Date granted
04/30/1998
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
1530 North 7th Street Suite 111, Terre Haute IN 47807
indianalicensing.org
ID 5924673
LAST UPDATED 2024-03-24 16:20:28 UTC

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