Indiana
Professional Licensing Agency
Austin Bancroft
Controlled Substance Registration-Osteopathic Physician
License number
02004205B
Date granted
05/01/2013
Date expires
10/31/2015
Class
Controlled Substance Registration-Osteopathic Physician
Status
Active
Address
304 Detroit St., La Porte IN 46350-2497
indianalicensing.org
ID 5806750
LAST UPDATED 2026-05-01 08:24:35 UTC
LAST UPDATED 2026-05-01 08:24:35 UTC
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